Bu yaz\u0131da, akut ba\u015flang\u0131\u00e7l\u0131 ve \u00e7oklu organ tutulumlu bir Cryptococcus neoformans menenjiti olgusu sunuldu. 44 ya\u015f\u0131nda erkek hasta, HIV infeksiyonu tan\u0131s\u0131yla antiretroviral tedavi (ART) ba\u015fland\u0131ktan bir ay sonra bulant\u0131, kusma, ba\u015f a\u011fr\u0131s\u0131 ve genel durumunda bozulma \u015fikayetleriyle yat\u0131r\u0131ld\u0131. Klinik bulgular ve inceleme sonu\u00e7lar\u0131yla pn\u00f6moni, retinit ve menenjit saptanan hastaya ampirik antibiyotik tedavisi ba\u015fland\u0131. Beyin-omurilik s\u0131v\u0131s\u0131 (BOS)\u2019n\u0131n \u00e7ini m\u00fcrekkebi preparat\u0131nda tomurcuklanm\u0131\u015f kaps\u00fcll\u00fc maya h\u00fccreleri g\u00f6r\u00fcld\u00fc. BOS\u2019ta kriptokok antijeni pozitifti ve BOS k\u00fclt\u00fcr\u00fcnde C. neoformans \u00fcredi. Hastan\u0131n tedavisine lipozomal amfoterisin B ve flukonazol eklendi. Renal biyopsiyle al\u0131nan b\u00f6brek dokusunun histopatolojik incelemesinde yayg\u0131n parenkimal kriptokokok tutulumu saptand\u0131. Antifungal tedavi 40. g\u00fcnden sonra oral flukonazolle s\u00fcrd\u00fcr\u00fcld\u00fc. 12 ay sonra CD4+ T h\u00fccresi say\u0131s\u0131 100\/mm3\u2019\u00fcn \u00fcst\u00fcne \u00e7\u0131k\u0131nca flukonazol kesildi. ART alt\u0131nda ve antifungal tedavi almaks\u0131z\u0131n izlenen hastan\u0131n y\u00fcksek kreatinin d\u00fczeyleri devam etti.\u00a0 Bir y\u0131ll\u0131k izlemin ard\u0131ndan son kreatinin de\u011feri\u00a0 2.4 mg\/dl idi. \u00d6zellikle yeni tan\u0131 alm\u0131\u015f HIV-pozitif olgularda CD4+ T h\u00fccresi say\u0131s\u0131 <100\/mm3 ve serum kriptokok antijeni pozitif ise, rehberlerin de belirtti\u011fi gibi BOS\u2019ta kriptokok antijeni ara\u015ft\u0131r\u0131lmal\u0131d\u0131r. Ayr\u0131ca renal fonksiyon bozuklu\u011fu olan HIV-pozitif hastalarda ay\u0131r\u0131c\u0131 tan\u0131da kriptokok infeksiyonu da d\u00fc\u015f\u00fcn\u00fclmeli ve en k\u0131sa zamanda b\u00f6brek biyopsileri yap\u0131lmal\u0131d\u0131r. HIV ile infekte olgularda kriptokok infeksiyonlar\u0131n\u0131n \u00e7oklu organ tutulumuyla seyredebilece\u011fi ak\u0131lda tutulmal\u0131d\u0131r. Tan\u0131n\u0131n erken konulmas\u0131 mortalite ve morbiditenin azalt\u0131lmas\u0131nda \u00f6nemlidir.<\/p>\n
\u00d6zet Bu yaz\u0131da, akut ba\u015flang\u0131\u00e7l\u0131 ve \u00e7oklu organ tutulumlu bir Cryptococcus neoformans menenjiti olgusu sunuldu. 44 ya\u015f\u0131nda erkek hasta, HIV infeksiyonu tan\u0131s\u0131yla antiretroviral tedavi (ART) ba\u015fland\u0131ktan bir ay sonra bulant\u0131, kusma, ba\u015f a\u011fr\u0131s\u0131 ve genel durumunda bozulma \u015fikayetleriyle yat\u0131r\u0131ld\u0131. Klinik bulgular ve inceleme sonu\u00e7lar\u0131yla pn\u00f6moni, retinit ve menenjit saptanan hastaya ampirik antibiyotik tedavisi ba\u015fland\u0131. Beyin-omurilik […]<\/p>\n","protected":false},"author":0,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5131],"tags":[4729,4727,3388,3228,2698],"class_list":["post-14753","post","type-post","status-publish","format-standard","hentry","category-olgu-sunumu","tag-akut-renal-hasar","tag-bobrek-hastaliklari","tag-cryptococcus-neoformans","tag-hiv","tag-menenjit"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/14753","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/comments?post=14753"}],"version-history":[{"count":0,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/14753\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/media?parent=14753"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/categories?post=14753"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/tags?post=14753"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
<\/br> Cite this article as<\/strong>: Sar\u0131g\u00fcl F, \u00dcser \u00dc, \u00d6ztoprak N. [Cryptococcus neoformans meningitis with renal involvement in an HIV-positive patient: A case report]. Klimik Derg. 2018; 31(2): 153-6. Turkish.<\/p>\n","protected":false},"excerpt":{"rendered":"