Özkan GÜNGÖR, Emel ADA, Aydanur KARGI, Pınar BALCI, Aydın ŞANLI, Eyüp Sabri UÇAN, Aşkın GÜLŞEN, Kemal Can TERTEMİZ, Emel CEYLAN, Uğural Nurbanu SEZAK, Avkan Vildan OĞUZ

Vorikonazol ile tedavi edilen dirençli pulmoner ve serebral aspergilloz olgusu

Invaziv pulmoner aspergillozis (İPA) immünsüpresif olgularda fungal akciğer infeksiyonlarının en sık nedenidir. Bu hastalıkta tanı güç, tedavi süresi değişken ve mortalite yüksektir. Serebral tutulumun eşlik ettiği olgularda prognoz daha da kötüdür. Usual interstisyel pnömoni nedeniyle takip edilen kortikosteroid ve azotioprin tedavisi alan hasta baş ağrısı ve ani görme kaybı nedeniyle başvurdu ve yapılan tetkikler sonrasında İPA ve serebral aspergillozis tanısı aldı. Olguya serebral ve pulmoner tutulum nedeniyle amfoterisin B lipid kompleks tedavisi verildi. Yanıt alınamaması üzerine hastaya vorikonazol tedavisi başlandı. İntraserebral etkinliği daha iyi olduğu bilinen vorikonazol ile başarılı bir şekilde tedavi edilen olguyu sunmayı uygun bulduk.

A case of resistant pulmonary and cerebral aspergillosis succesfully treated with voriconazole

Invasive pulmonary aspergillosis (IPA) is the most common fungal pulmonary infection in immunocompromised patients. In this disease, it is hard to diagnose, it’s therapy process is variable and mortality is high. Prognosis is even worse in the cases which have cerebral aspergillosis. The patient was following up as a diagnosis of usual interstitial pneumonia and treating with corticosteroids and azothiopurine. Patient attented our clinic with headache and lose of vision. IPA and cerebral aspergillosis was the diagnosis as his examinations. Amphotericine B lipid complex treatment were given because of pulmonary and cerebral aspergillosis. Voriconazole was the second threapy because of the no response. Voriconazole is more effective in cerebral aspergillozis and treated this patient succesfully.

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