Neriman Defne ALTINTAŞ, Aslıhan GÜRÜN KAYA, Aydın ÇİLEDAĞ, Akın KAYA, Miraç ÖZ, Serhat EROL, Fatma ÇİFTÇİ, Çağlar UZUN, Leyla TALAN, Övgü VELİOĞLU YAKUT, Ezgi GÜLTEN, Zeynep Ceren KARAHAN

Trakeostomili bir hastada COVID-19 enfeksiyonunun başarılı tedavisi

Yeni tip Coronavirüs hastalığı (COVID-19) atipik pnömoniye neden olmaktadır. Trakeostomili hastalarda sık karşılaşılan bakteriyel enfeksiyonlarla coronavirüs birlikteliği görülebilmektedir. Olgumuz 61 yaşında trakeostomi ile takip edilen erkek hasta; nefes darlığı, ateş ve trakeal sekresyonlarda artış ile hastaneye başvurdu. Laboratuvar bulgularında lenfopeni ve C-reaktif protein ve prokalsitonin düzeylerinde artış saptandı. Toraks bilgisayarlı tomografisinde subplevral alanlarda konsolidasyonlar ve buzlu cam opasiteleri daha belirgin olarak görüldü. Kombine nazofarengeal/orofarengeal sürüntülerin SARS-CoV-2 RNA için RT-PCR analizi ardışık olarak iki kez negatif saptanmasına rağmen endotrakeal aspirat örneğinde pozitiflik görüldü. Endotrakeal aspirat örneğinin bakteri kültüründe Pseudomonas aeruginosa ve Stenotrophomonas maltophilia üremeleri saptandı. Sonuç olarak SARS-CoV-2 için üst hava yolundan alınan örnekler negatifse, mikrobiyolojik örnekler mümkünse alt solunum yolundan alınmalıdır. Olgumuz literatürdeki COVID-19 tanısı ile başarılı olarak tedavi edilen sunulmuş ilk olgudur.

Successful treatment of COVID-19 infection in a patient with tracheostomy

Coronavirus disease 2019 (COVID-19) has been demonstrated to be the cause of emerging atypical pneumonia. In patients with tracheostomy, coro-navirus hypothetically coexists with well-known bacterial agents. A 61-year-old male patient with tracheostomy was admitted to the hospital with dys-pnea, fever and increased tracheal secretions. Laboratory findings revealed lymphopenia and elevated C-reactive protein and procalcitonin levels. Chest computed tomography showed consolidation areas and ground-glass opaci-ties more prominent in subpleural areas. Although; two consecutive RT-PCR analyses of combined nasopharengeal/oropharengeal swabs were found to be negative for SARS-CoV-2 RNA, positivity was reported for endotracheal aspirate (ETA) sample. Significant growth of Pseudomonas aeruginosa and Stenotrophomonas maltophilia was detected in the bacterial culture of ETA sample. In conclusion, clinical samples for SARS-CoV-2 should be obtained through the lower respiratory tract, if possible and if upper airway samples are negative. To the best our knowledge, our paper is the first report of the patient with tracheostomy who was treated successfully for COVID-19.

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