Özofagusun fungal enfeksiyonları; tek merkez deneyimi
Giriş ve Amaç: Araştırmamızda hastanemizde çeşitli endikasyonlar ile üst gastrointestinal sistem endoskopisi yapılan hastalarda özofagus fungal enfeksiyonlarının sıklığını, başvuru semptomlarının dağılımını, buna zemin hazırlayan durumları değerlendirmeye çalıştık. Gereç ve Yöntem: 2015-2019 yılları arasında hastanemize başvuran ve üst gastrointestinal sistem endoskopisi yapılan 2862 hastadan endoskopik olarak özofagusta fungal enfeksiyon tespit edilen ve mikrobiyolojik olarak bu tanısı doğrulanan 33 hasta değerlendirmeye alındı. Bulgular: Toplam 2862 hastanın 33 (%1,2) tanesinde özofagusta fungal enfeksiyon tespit edildi. Eşlik eden hastalık olarak en sık %71 ile reflü özofajit zemininde fungal enfeksiyon gelişmişti. Hiçbir hastada insan bağışıklık yetmezliği virüsü pozitifliği tespit edilemedi. Hastaların %27,3’ünde immünsupresyona neden olan bir patoloji ya da ilaç kullanımı mevcut iken %72,7’sinde böyle bir neden tespit edilemedi. Hastaların başvuru şikayeti olguların %21.2’sinde disfaji, %6.1’inde hıçkırık, %21.2’sinde reflü semptomları, %6.1’inde ses kısıklığı, %6.1’inde kilo kaybı, %15.2’sinde bulantı-kusma iken %42.4 ile hastaların çoğunluğunda mide ağrısı gibi klasik bir dispeptik yakınma şeklindeydi. Sonuç: Dünyada Kandida özofajitinin en sık nedeni insan bağışıklık yetmezliği virüsü enfeksiyonu, maligniteler ve immünsüpresyon yaratan durumlardır. Bizim hastalarımızda Kandida enfeksiyonuna daha çok reflü özofajit eşlik etmekte iken sadece %15 hastada enfeksiyon immünsüpresyon yaratan bir durumda gelişmişti. Bulgularımız insan bağışıklık yetmezliği virüsü negatif hasta profilindeki dünya literatür verileri ile uyumu bulundu.
Anahtar Kelimeler:
Özofagusun fungal enfeksiyonları, kandida özofajiti, kandidiyazis
Fungal infections of the esophagus: Single center experience
Background and Aims: Our study investigated the prevalence of esophageal fungal infections, distribution of presenting symptoms, and predisposing conditions in the patients undergoing upper gastrointestinal endoscopy for various reasons at our hospital. Materials and Methods: Overall, 2862 patients presented to our hospital and underwent upper gastrointestinal endoscopy between 2015 and 2019. Thirty-three of these patients who were endoscopically determined and microbiologically confirmed to have esophageal fungal infections were included. Results: Esophageal fungal infection was found in 33 (1.2%) of 2862 patients. Fungal infections developed most frequently as a comorbid disease in the setting of reflux esophagitis, with a rate of 71%. No patient was found to have human immunodeficiency virus seropositivity. Even though 27.3% of patients had pathological or drug-induced immune suppression, no such findings were noted in 72.7% of patients. The presenting complaint was dysphagia in 21.2% of patients, hiccough in 6.1%, reflux symptoms in 21.2%, hoarseness in 6.1%, weight loss in 6.1%, and nausea or vomiting in 15.2%; however, in most patients, the presenting complaint was a classical dyspeptic complaint, such as stomach ache (42.4%). Conclusion: The most common causes of Candida esophagitis worldwide are human immunodeficiency virus infection, malignancies, and conditions that result in immune suppression. Even though Candida esophagitis was more commonly associated with reflux esophagitis in our patients, fungal infection was also observed in 15% of patients along with diseases that rendered them immunocompromized. Our results were concordant with the literature data regarding the clinical profile of patients who are human immunodeficiency virus negative.
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- ISSN: 1302-5422
- Başlangıç: 2010
- Yayıncı: Türk Gastroenteroloji Vakfı
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