İrem UNAT, Kemal TEKİN, Mehmet Ozan DURMAZ, Musa Barış AYKAN, Tuğrul HOŞBUL

BAĞIŞIKLIĞI BASKILANMIŞ, PERİTONEAL KARSİNOMATOZİSLİ BİR HASTADA LISTERIA MONOCYTOGENES’E BAĞLI SEPSİS: OLGU SUNUMU

Listeria monocytogenes, immünokompetan bireylerde genellikle kontamine olmuş gıdaların tüketilmesi ile kendi kendini sınırlayan gastroenterit tablosuna, immun sistemi baskılanmış bireylerde ve yenidoğanda ise ölümcül enfeksiyonlara yol açabilen fırsatçı bir enfeksiyöz ajandır. Karın içi tümörlerin lokal etkileri, immün yanıtın baskılanması, peritoneal membran ve gastrointestinal sistemin bütünlüğünü bozan operasyonlar patojen kaynaklı invaziv enfeksiyon riskinde artışa neden olabilir. Abdominal ve pelvik maligniteleri olan hastaların tedavisinde uygulanan sitoredüktif cerrahi girişimler, sistemik ve/veya hipertermik intraperitoneal kemoterapi (HİPEK) hastalıksız sağkalımı arttırmakla birlikte gastrointestinal ve sistemik komplikasyonlar yoluyla L. monocytogenes’in neden olduğu enfeksiyonlara zemin hazırlayabilir. Bu olgu sunumunda, sistemik kemoterapi ve sitoredüktif cerrahi ile kombine HİPEK tedavileri sonrası L. monocytogenes’e bağlı sepsis tanısı alan 71 yaşında bir erkek hasta tartışılmış ve L. monocytogenes’in kanser, cerrahi işlem ve kematerapötik ajanların kullanımı gibi sebeplerle immün sistemi baskılanmış bireylerde sistemik ve hayatı tehdit edici enfeksiyonlara neden olabileceği konusunda klinik ve laboratuvar farkındalığı yaratmak amaçlanmıştır.

Anahtar Kelimeler:

Hipertermik intraperitoneal kemoterapi, Listeria monocytogenes, peritoneal karsinomatozis, sistemik kemoterapi, sepsis

SEPSIS DUE TO LISTERIA MONOCYTOGENES IN AN IMMUNOCOMPROMISED PATIENT WITH PERITONEAL CARCINOMATOSIS: A CASE REPORT

Listeria monocytogenes is an opportunistic infectious agent that can cause self-limiting gastroenteritis in immunocompetent individuals, usually with the consumption of contaminated foods, and fatal infections in immunocompromised individuals and newborns. Local effects of intra-abdominal tumors, immune response suppression, and operations that disrupt the integrity of the peritoneal membrane and gastrointestinal tract may increase the risk of pathogen-induced invasive infection. Although cytoreductive surgical interventions, systemic and/or hyperthermic intraperitoneal chemotherapy (HIPEC) applied in the treatment of patients with abdominal and pelvic malignancies increase disease-free survival, they may predispose to infections caused by L. monocytogenes through gastrointestinal and systemic complications. In this case report, a 71-year-old male patient diagnosed with sepsis due to L. monocytogenes after treatments with systemic chemotherapy and cytoreductive surgery combined with HIPEC is discussed. It is aimed to raise clinical and laboratory awareness that L. monocytogenes may cause systemic and life-threatening infections in individuals whose immune system is suppressed due to cancer, surgical procedures, and the use of chemotherapeutic agents.

Keywords:

Hyperthermic intraperitoneal chemotherapy, Listeria monocytogenes, peritoneal carcinomatosis, systemic chemotherapy, sepsis,

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