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Salmonella türleri, ülkemizde gastroenteritin sık görülen bakteriyel etkenlerinden olmakla beraber, gastroenterit dışında tifo-paratifo, bakteriyemi, metastatik enfeksiyonlar ve kronik taşıyıcılık gibi çeşitli enfeksiyon tablolarına neden olabilmektedir. Bu olgu sunumunda Salmonella paratyphi A ’ya bağlı nadir görülen pansitopeni, akut böbrek yetmezliği ve ileus tablosu olan olgumuzu paylaşmayı amaçladık. Bilinen hipertansiyon dışında kronik hastalık öyküsü olmayan, 77 yaşında erkek hasta, ateş yüksekliği, bulantı-kusma, karın ağrısı, ishal şikayetleri ile acil servise başvurdu. Hasta akut gastroenterit, akut böbrek yetmezliği (ABY) ve pansitopeni tanıları ile kliniğimize yatırıldı. Hastanın kan ve gayta kültürleri alınıp, hastaya ampirik olarak siprofloksasin tedavisi başlanıldı. Hastanın tedavi ile ishali ve pansitopenisi düzeldi. Ancak hastada yatışının 4. gününde ileus tablosu ve bilinç bulanıklığının gelişmesi üzerine hasta yoğun bakım ünitesine transfer edildi. Hastanın gayta kültüründe Salmonella-Shigella cinsi bakteri üremesi olmadı, ancak kan kültürlerinde ampisiline dirençli; seftriakson, sefotaksim, trimetoprim-sülfametoksazol, siprofloksasine duyarlı Salmonella paratyphi A üremesi oldu. Hastanın antibiyotik tedavisi değiştirilmedi. Hastaya 2 hafta süreyle intravenöz 2x200 mg/gün siprofloksasin tedavisi uygulandı. Hastanın hemodiyaliz ihtiyacı olmadan akut böbrek yetmezliği tablosu düzeldi ve yoğun bakım ünitesinden servisimize alındı ve hastamız şifa ile taburcu edildi.
Although Salmonella species are one of the common bacterial causative microorganism of gastroenteritis in our country, but can also cause different types of infections such as typho-paratyphoid, bacteriemia, metastatic infections and chronic carriage besides gastroenteritis. In this case report, we aimed to a rare offer a case of pancytopenia, acute renal failure and ileus due to Salmonella paratyphi A. A 77-year-old man without history of known chronic disease other than hypertension, presented to the emergency department with fever, nausea, vomiting, abdominal pain and diarrhea. The patient was hospitalized with the diagnosis of acute gastroenteritis, acute renal failure and pancytopenia. Blood and stool cultures were taken and ciprofloxacin treatment was started empirically. With antibiotic treatment, the patient's condition began improving in terms of resolution of diarrhea and pancytopenia. However, the patient was transferred to the intensive care unit on the 4th day of hospitalization as the development of ileus and confusion. Salmonella-Shigella bacterial growth was not observed in the patient's stool culture, but ampicillin resistant, ceftriaxone, cefotaxime, trimethoprim/sulfamethoxazole, ciprofloxacin susceptible Salmonella paratyphi A was detected in his blood culture. The patient’s antibiotic treatment was not altered. The patient had received ciprofloxacin therapy with renal dose of 2x200 mg/day for 2 weeks as intravenously. The patient's acute renal failure table is resolved without hemodialysis. The patient was transferred to our clinic from the intensive care unit and the patient was discharged by healing.
Although Salmonella species are are one of the common bacterial causative microorganism of gastroenteritis in our country, but also can cause different type of infections such as typho-paratyphoid, bacteriemia, metastatic infections and chronic carriage besides gastroenteritis. In this case report, we aimed to a rare offer a case of pancytopenia, acute renal failure and ileus due to Salmonella paratyphi A. A 77-year-old man without history of known chronic disease other than hypertension, presented to the emergency department with fever, nausea, vomiting, abdominal pain and diarrhea. The patient was hospitalized with the diagnosis of acute gastroenteritis, acute renal failure and pancytopenia. Blood and stool cultures were taken and ciprofloxacin treatment was started empirically. With antibiotic treatment, the patient's condition started improving in terms of resolution of diarrhea and pancytopenia. However, the patient was transferred to the intensive care unit on the 4th day of ospitalization as development of ileus and confusion. Salmonella-Shigella bacterial growth was not observed in the patient's stool culture, but ampicillin resistant, ceftriaxone, cefotaxime, trimethoprim/sulfamethoxazole, ciprofloxacin susceptible Salmonella paratyphi A was detected in his blood culture. The patient's antibiotic treatment was not altered. The patient had received ciprofloxacin therapy with renal dose of 2x200 mg/day for 2 weeks as intravenously. The patient's acute renal failure table resolved without hemodialysis. The patient was transferred to our clinic from the intensive care unit and the patient was discharged by healing.
Alan : Sağlık Bilimleri
Dergi Türü : Uluslararası
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