Ali Bülent CENGİZ, Hayriye Uğur ÖZÇELİK, Nural KİPER, Diclehan ORHAN, Mithat HALİLOĞLU, Nagehan EMİRALİOĞLU, Deniz ERSÖZ DOĞRU, Hatice Nursun ÖZCAN, Elmas Ebru YALÇIN

Bağışıklık sistemi normal bir olguda kist hidatik cerrahisi sonrası kronik nekrotizan pulmoner aspergillozis gelişimi

Kronik nekrotizan pulmoner aspergillozis, bağışıklık sistemi baskılanmamışolan kişilerde çevrede sıklıkla görülen Aspergillus fumigatus'abağlı gelişen bir durumdur. Kronik nekrotizan pulmoner aspergillozisile ilişkili altta yatan farklı nedenler vardır. Tüberküloz, tüberküloz dışımikobakteri infeksiyonları, allerjik bronkopulmoner aspergillosiskronik nekrotizan pulmoner aspergillozis gelişiminde öncülük edenaltta yatan risk faktörleridir. Ekinokok kist kavitesinde kronik nekrotizanpulmoner aspergillozis gelişimi nadir görülmektedir; optimal tedavi seçimi ve tedavi süresi de kesin bilinmemektedir. Burada hidatik kist tanısıyla kistektomi operasyonundan altı yıl sonra kronik nekrotizan pulmoner aspergillozis gelişen ve varikanazol ile başarılı şekilde tedavi edilen bir olgu sunulmuştur.

Chronic necrotizing pulmonary aspergillosis in an immunocompetent patient after the surgery of hydatid cyst

Chronic necrotizing pulmonary aspergillosis (CNPA) is a condition caused by the ubiquitous fungus Aspergillus fumigatus in nonimmunocompromisedindividuals. Numerous underlying conditions have been associated with CNPA. Tuberculosis, non-tuberculousmycobacterial infection and allergic bronchopulmonary aspergillosis (ABPA) remain the predominant risk factors for development ofCNPA. Development of CNPA in echinococcal cyst cavities is very rare and the optimal therapeutic regimen and treatment durationhave not been established. Here, we present a case of CNPA developed six years after the cystectomy operation of hydatid cyst andtreated with voriconazole successfully.

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1. Parra I, Remacha A, Rezusta A, Suarez D, Suarez J, Herreras JA, et al. Chronic necrotizing pulmonary aspergillosis. Med Mycol 2004;42:369-71.
2. Smith NL, Denning DW. Underlying conditions in chronic pulmonary aspergillosis including simple aspergilloma. Eur Respir J 2011;37:865-72.
3. Shakoor MT, Ayub S, Ayub Z, Mahmood F. Fulminant invasive aspergillosis of the mediastinum in an immunocompetent host: a case report. J Med Case Rep 2012;6:311.
4. Saito T, Fujiuchi S, Tao Y, Sasaki Y, Ogawa K, Suzuki K, et al. Efficacy and safety of voriconazole in the treatment of chronic pulmonary aspergillosis: experience in Japan. Infection 2012;40:661-7.
5. Nam HS, Jeon K, Um SW, Suh GY, Chung MP, Kim H, et al. Clinical characteristics and treatment outcomes of chronic necrotizing pulmonary aspergillosis: a review of 43 cases. Int J Infect Dis 2010;14:e479-82.
6. Soubani AO, Chandrasekar PH. The clinical spectrum of pulmonary aspergillosis. Chest 2002;121:1988-99.
7. Jin E, Wang LM, Li QY, Feng X, Ma SL. Chronic necrotizing pulmonary aspergillosis in an immunocompetent patient: report of a rare case. Infection 2014;42:565-8.
8. Regnard JF, Icard P, Nicolosi M, Spagiarri L, Magdeleinat P, Jauffret B, et al. Aspergilloma: a series of 89 surgical cases. Ann Thorac Surg 2000;69:898-903.
9. Ulasan NG, Dural K, Yildirim E, Ozisik K, Sakinci U. An intracavitary aspergilloma after eccinococcal cystectomy. J Cardiovasc Surg 2003;44:289-90.
10. Aydemir B, Aydemir C, Okay T, Celik M, Dogusoy I. An aspergilloma in echinicoccal cyst cavity. Thorac Cardiovasc Surg 2006;54:353-5.
11. Walsh TJ, Anaissie EJ, Denning DW, Herbrecht R, Kontoyiannis DP, Marr KA, et al. Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America. Clin Infect Dis 2008;46:327-60.