Bronkoskopik Lavaj Sitolojisiyle Te�his Edilen �mm�nokompetan Bir Hastada Pulmoner T�berk�lozu Taklid Eden Pulmoner Nokardiozis

Abal�, H�lya; U�ur Chousein, Efsun Gonca; H�r��n Cenger, Derya; Fener, Neslihan

Cilt : 13 Say� : 3 Y�l : 2024

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Bronkoskopik Lavaj Sitolojisiyle Te�his Edilen �mm�nokompetan Bir Hastada Pulmoner T�berk�lozu Taklid Eden Pulmoner Nokardiozis [Respir Case Rep]

Respir Case Rep. 2023; 12(2): 46-49 | DOI: 10.5505/respircase.2023.57983

Bronkoskopik Lavaj Sitolojisiyle Te�his Edilen �mm�nokompetan Bir Hastada Pulmoner T�berk�lozu Taklid Eden Pulmoner Nokardiozis

H�lya Abal�¹, Efsun Gonca U�ur Chousein¹, Derya H�r��n Cenger², Neslihan Fener³
¹Yedikule G��s Hastal�klar� ve G��s Cerrahisi E�itim ve Ara�t�rma Hastanesi, G��s Hastal�klar� Anabilim Dal�, �stanbul
²Yedikule G��s Hastal�klar� ve G��s Cerrahisi E�itim ve Ara�t�rma Hastanesi, Enfeksiyon Hastal�klar� Anabilim Dal�, �stanbul
³Yedikule G��s Hastal�klar� ve G��s Cerrahisi E�itim ve Ara�t�rma Hastanesi, Patoloji Anabilim Dal�, �stanbul

Nokardiya enfeksiyonlar�, ba��kl�� bask�lanm�� ve organ nakli olan hastalarda s�k g�r�l�r, ayr�ca, Nokardiya t�rleri imm�nokompetan hastalarda nadiren enfeksiyona neden olur. Pulmoner nokardiozis, Nokardiya t�rlerinin en s�k g�r�len klinik manifestasyonudur ve T�rkiye gibi pulmoner t�berk�loz (TB) i�in y�ksek riskli b�lgelerde s�kl�kla pulmoner t�berk�loz gibi bir�ok pulmoner hastal�� taklid edebilir. Anamnez, klinik semptomlar ve radyolojik bulgulara g�re pulmoner t�berk�lozu taklit eden pulmoner nokardiozis tan�s� alan nadir bir imm�nokompetan olguyu sunuyoruz. Bronkoskopik lavaj�n aside diren�li boyamas� ve real-time polimeraz zincir reaksiyonu TB i�in negatifti ve k�lt�rde hi�bir Mikobakteri t�r� �remedi. �ki benzer hastal��n ay�r�c� tan�s� lavaj sitolojisi ile yap�ld�. �ki ayl�k k�sa s�reli bir tedavi ile dramatik bir iyile�me g�zlendi.

Anahtar Kelimeler: Pulmoner nokardiozis, t�berk�loz, imm�nokompetan, lavaj sitolojisi

Pulmonary Nocardiosis Mimicking Pulmonary Tuberculosis in an Immunocompetent Patient Diagnosed by Cytology of Bronchoscopic Lavage

H�lya Abal�¹, Efsun Gonca U�ur Chousein¹, Derya H�r��n Cenger², Neslihan Fener³
¹Department of Chest Diseases, Yedikule Chest Diseases and Tho-racic Surgery Training and Research Hospital, �stanbul, T�rkiye
²Department of Infectious Diseases, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, �stanbul, T�rkiye
³Department of Pathology, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, �stanbul, T�rkiye

Nocardia infections are common in immunocompromised and organ transplant patients, although Nocardia species only rarely cause infections in immunocompetent patients. Pulmonary nocardiosis is the most common clinical manifestation of Nocardia species, and may imitate several pulmonary diseases, such as pulmonary tuberculosis (TB) in such high-risk settings for TB as T�rkiye. We present here a rare case of an immunocompetent patient with pulmonary nocardiosis mimicking tuberculosis in terms of the history, clinical symptoms and radiological findings. Acid-fast staining and real-time polymerase chain reaction testing of the bronchoscopic lavage were negative for TB, and no Mycobacterium species proliferated in the culture. Two similar diseases were differentiated by lavage cytology. The patient improved dramatically following a short course of treatment over two months.

Keywords: Pulmonary nocardiosis, tuberculosis, im-munocompetent, lavage cytology

Sorumlu Yazar: H�lya Abal�, T�rkiye
Makale Dili: �ngilizce

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