B�brek Nakil Al�c�s� Olan Bir Hastada Rhodococcus equi �li�kili Bakteriyemi ve Kaviter Akci�er Lezyonu: Nadir Bir Olgu Sunumu

Kang�l, Furkan; Kang�l, Handan; Selimo�lu �en, Hadice; Y�lmaz, S�reyya; Uzuner, Nurullah

Cilt : 11 Say� : 3 Y�l : 2024

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B�brek Nakil Al�c�s� Olan Bir Hastada Rhodococcus equi �li�kili Bakteriyemi ve Kaviter Akci�er Lezyonu: Nadir Bir Olgu Sunumu [Respir Case Rep]

Respir Case Rep. 2022; 11(3): 132-137 | DOI: 10.5505/respircase.2022.54366

B�brek Nakil Al�c�s� Olan Bir Hastada Rhodococcus equi �li�kili Bakteriyemi ve Kaviter Akci�er Lezyonu: Nadir Bir Olgu Sunumu

Furkan Kang�l¹, Handan Kang�l², Hadice Selimo�lu �en¹, S�reyya Y�lmaz¹, Nurullah Uzuner²
¹Dicle �niversitesi T�p Fak�ltesi G��s Hastal�klar� Anabilim Dal�, Diyarbak�r
²Dicle �niversitesi T�p Fak�ltesi Mikrobiyoloji Hastal�klar� Anabilim Dal�, Diyarbak�r

Rhodococcus equi is HIV pozitif ve organ nakil al�c�s� olan immuns�presif hastalarda �zellikle t�berk�loz ile s�kl�kla kar��an kaviter akci�er infeksiyonuna neden olan nadir bir etkendir. Altm�� dokuz ya��nda b�brek transplant al�c�s� ve imm�ns�presif tedavi alan erkek hasta 6 ayd�r devam eden kilo kayb�, �ks�r�k ve hemoptizi semptomlar� olmas� �zerine d�� merkeze ba�vurmu�. �ekilen bilgisayarl� tomografide sol akci�er alt lob �st segmentte kavite saptanm��. Malignite d��n�lmesi �zerine PET-CT �ekilmi� ve y�ksek SUV-max tutulumu tespit edilmi�. Hasta hastanemize ba�vurdu�unda mevcut �ikayetleri devam etmekteydi. Al�nan Bronkoalveolar Lavaj k�lt�r�nde ve kan k�lt�rlerinde R. equi �remesi oldu. Hasta ent�be edilerek mekanik ventilat�r ile takip edildi. Kontrol ETA (endotrakeal aspirat) k�lt�r�nde A. baumannii �remesi oldu. Bunun �zerine tedaviye kolistin de eklendi. Hasta tedavisinin 23. g�n�nde kolistine ba�l� nefrotoksisite nedeniyle exitus oldu. Bildi�imiz kadar�yla bu olgu �lkemizde R. equi kaviter pn�monisinin R. equi bakteriyemisi ile birlikte g�r�ld�� ilk olgudur.

Anahtar Kelimeler: Rhodococcus equi, Ba��kl�� bask�lanm�� konak, Kaviter akci�er lezyonu

Rhodococcus equi Related Bacteremia and Cavitary Lung Lesion in a Patient Receiving Renal Transplant: A Rare Case Report

Furkan Kang�l¹, Handan Kang�l², Hadice Selimo�lu �en¹, S�reyya Y�lmaz¹, Nurullah Uzuner²
¹Department of Pulmonary Diseases, Faculty of Medicine, Dicle University, Diyarbak�r, T�rkiye
²Department of Medical Microbiology, Faculty of Medicine, Dicle University, Diyarbak�r, T�rkiye

Rhodococcus equi is a rare cause of cavitary lung infection that is often mistaken for tuberculosis in immunosuppressed patients who are HIV positive and in organ transplant recipients. A 69-year-old male kidney transplant patient was admitted to an external healthcare center with complaints of weight loss, cough and hemoptysis that had started 6 months earlier. A computed tomography revealed a cavity in the upper segment of the left lung lower lobe, and a PET-CT revealed a high SUV-max uptake. Upon application to our hospital, the same symptoms were identified, along with R. equi growth observed in Bronchoalveolar Lavage and blood cultures. The patient was followed up with mechanical ventilator as intubated. Acinetobacter baumannii grew in the control ETA (endotracheal aspirate) culture on the 6th day of hospitalization, and he died subsequently on the 23rd day of hospitalization from colistin-induced nephrotoxicity. To the best of our knowledge this is the first case in which R. equi cavitary pneumonia has been seen together with R. equi bacteremia in our country.

Keywords: Rhodococcus equi, Immunocompromised host, Cavitary lung lesion

Olgunun G�r�nt� Kesitleri

Sorumlu Yazar: Furkan Kang�l, T�rkiye
Makale Dili: �ngilizce

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