Bir Olgu Nedeniyle Yenidoğanda Ölümcül Seyirli Boğmaca Enfeksiyonu

Boğmaca, etkeni pleomorfik gram negatif bir basil olan Bordetella pertussisin neden olduğu son derece bulaşıcı ve potansiyel olarak yaşamı tehdit eden bir solunum yolu enfeksiyonudur. Yaşamın ilk üç ayında sıklıkla şiddetli ve genellikle ölümcüldür. Hemen tüm ölümcül seyreden vakalarda aşırı lökositoz ve pulmoner hipertansiyon eşlik eder. Hastalığa uygun şartlarda alınmış nazofarengeal sürüntüden yapılan kültür veya PCR ile tanı konulmalıdır. 19 günlük erkek bebek ateş, taşikardi ve solunum semptomları nedeniyle yenidoğan yoğun bakım ünitemize kabul edildi. Hastanın klinik durumu giderek kötüleşti ve sonradan solunum yetmezliği gelişti. Hastaya endotrakeal entübasyon yapıldı ve mekanik ventilasyon desteği verildi. Beyaz küre sayısı 124000/mm3’e kadar artış gösterdi ve pulmoner hipertansiyon saptandı. Hasta ve annesinin nazofarenks sürüntü örneği alındı. Alınan örneklerde hasta ve annede Bordatella pertussis PCR pozitifliği saptandı. Hastaneye yatışının 3. gününde kliniği giderek bozulan, ödem, bradikardi ve hipotansiyonu gözlenen olgu, yatışının 4. gününde kaybedildi. Olgu, boğmaca enfeksiyonunun yenidoğan döneminde ölümcül seyirli olabileceğine dikkat çekmek amacıyla sunulmuştur

Pages 30-32

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