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PREMATÜRE BEBEKTE RENAL KANDiDiYAZIS (OLGU SUNUMU)

RENAL CANDIDIASIS IN PRETERM INFANT (CASE REPORT)

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Abstract (2. Language): 
The incidence of systemic and renal candidiasis has increased with the improved survival of preterm infants, widespread use of broad-spectrum antibiotics, intravascular catheters and total parenteral nutrition. A one day old boy was admitted to the hospital be¬cause of prematurity. His general condition deteriora¬ted with hypoglysemic attacks and hematemesis on the third day. He was treated with broad spectrum antibi¬otics. Three days after the cessation of treatment the left kidney was 4-5 cm palpable. Candida albicans i>105 colonies per cc) was detected in three consecu¬tive urine samples. Dilatation of the collecting system including echodense material inside was found in the left kidney by abdominal ultrasonography. He was di¬agnosed as renal candidiasis (candidial bezoar) and was started on intravenous fluconasole (3 mglkglday) therapy. On the 7 th day of therapy his kidney was not palpable, ultrasonographic findings were normal and urine culture was free from Candida. His clinical con¬dition and renal functions, also demonstrated by Tc99-DMSA renal scanning were normal. In this case report, we want to emphasize the im¬portance of early treatment in Candida infection when the typical ultrasonographic findings are demonstra¬ted and supported by urine and blood culture.
Abstract (Original Language): 
Prematür bebeklerde yaşama şansının artması, geniş spektrumlu antibiyotiklerin yaygın kullanımı, intravasküler ve total parenteral beslenme uygulama¬larındaki artış, sistemik ve renal kandidiyazis olgula¬rının insidansını artırmıştır. Prematürelik nedeniyle hastanemize başvuran ve yatışının 3. günü genel durumu bozulan, hipoglisemi atakları, hematemezi olan hastaya sepsis tanısıyla uzun süreli geniş spektrumlu antibiyotik kombinas¬yonları uygulandı. Takibinde sol böbreği 4-5 cm ele gelen, idrar kültüründe 3 kez 100.000 germ/ml den fazla Candida üreyen hastanın, abdominal ultraso-nografisinde sol böbreğin toplayıcı sistemlerinin ge¬niş ve ekojenik granülasyon içerdiği saptandı. Bu bul¬gularla renal kandidiyazis tanısıyla fluconasole 3 mglkg/günden I.V tedaviye başlandı. Tedavinin 7. günü kitlesi kaybolan, ultrasonografik bulguları düze¬len, kültürde üreme olmayan hastanın kontrollerinde idrar bulguları, böbrek fonsiyonları, Tc" DMSA re¬nal scanning normal bulundu. Bu olgu sunumuyla renal kandidiyazis ultrasonog-rafi bulgularının tipik olması ve bulgunun idrar, kan kültürleriyle desteklenmesi durumunda acil tedaviye başlanmasının önemi vurgulanmak istendi.
FULL TEXT (PDF): 
62-65

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