Sema KEÇELİ, Devrim DÜNDAR, Aysun ŞİKAR AKTÜRK, Rebiay KIRAN

Kronik Lenfositik Lösemili Hastanın Subkütan Deri Enfeksiyonunda Acremonium Türlerinin İzolasyonu

Kutanöz Acremonium enfeksiyonları insanlarda nadir görülmektedir. Burada Acremonium sp. bağlı subkütanöz enfeksiyon gelişen kronik lenfositik lösemili bir olgu sunulmaktadır. Olgunun ilk klinikbelirtisi, sol bacak alt bölge dış yan duvarında meydana gelen yara lezyonu idi. Lezyondan alınan derin doku biyopsi örneğinin mantar kültüründe Acremonium sp. izole edildi. Bakteriyel kültürde Enterecoccus faecalis, E. clocea ve Candida albicans izole edildi. Patolojik inceleme sonucu piyoderma gangrenosum ve T hücre lenfo proliferatif lezyon olarak sonuçlandı. Bu nedenle olgunun tanısı, kombine bakteriyel ve fungal enfeksiyon, ayrıca pyoderma gangrenosum olarak belirlendi. Olgumuza ampisilin/sulbaktam, metilprednizolon, topikalnaftifin, fusidikasid vei trakonazol tedavisi verildi. Aynı zamanda kemoterapi protokolüne devam edildi. Itrakonazol tedavisinden sonar lezyonda iyileşme gözlendi.

Anahtar Kelimeler:

Acremonium, fungus, lösemi, deri, enfeksiyon, immünsupresyon, ıtrakanazol, amfoterisin B

Isolation Of Acremonium sp. From Subcutaneous Skin Infection Of A Patient With Chronic Lymphocytic Leukemia

Cutaneous Acremonium infections in humans is rare. We report a patient with chronic lymphocytic leukemia who developed subcutaneous infection due to Acremonium sp. A wound lesion on distal wall of left lower leg was the first clinical manifestation of the patient. Fungal culture of deep tissue biopsy from the lesion revealed Acremonium species. In bacterial cultures Enterecoccus faecalis, E. clocea and Candida albicans were isolated. Pathologic investigation resulted as pyoderma gangrenosum and T cell lymphoproliferative lesion. Thus, the diagnosis of patient was considered as combined bacterial and fungal infection plus pyoderma gangrenosum. Thus, the patient was treated with ampicillin/sulbactam, methil prednisolone, topical naftifin and fucidic acid and itraconazole. The chemotherapy protocol was continued at the same time. Healing of the lesion was observed after ıtracanazoleteratment.

Keywords:

Acremonium, fungus, leukemia, skin, infection, immunosuppresion, itraconazole, amphotericin B,

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