Publication: Mikoplazma Pnömonisine Bağlı Soğuk_x000D_
Agglutinin Hastalığı, Sık Görülen Hastalığın_x000D_
Az Görülen Komplikasyonu
Abstract
On dört yaşında kız hasta 3 gündür süren yüksek ateş ve öksürük yakınması ile başvurdu.Yakınmaları başladıktan sonra oseltamivir kullanmaya başladığı öğrenildi. Fizik incelemesinde, sol akciğer alt ve orta zonlarda solunum seslerinde azalma ve sağ akciğerde krepitanralleri mevcut idi. Laboratuvar incelemesinde hemoglobin 10.6 g/dL, hematokrit %33.5,MCV 76.5 fL, beyaz küre sayısı 5.97 bin /uL, trombosit sayısı 180 bin/uL, CRP 205.6 mg/L,prokalsitonin 1.28 ng/mL idi. Posteroarterior (PA) akciğer grafisinde, sol akciğer orta ve altzonlarında lober konsolidasyon, sağ akciğer alt zonda infiltrasyon ile uyumlu görüntü mevcuttu. Hastaya seftriakson, klaritromisin ve teikoplanin tedavileri başlandı. Tedavinin 3.gününde ateşleri düştü ve genel durumu düzeldi. Tedavinin 10. çekilen PA akciğer grafibulguları belirgin düzeldi ancak alınan kontrol tetkiklerinde hemoglobini 10.8 g/dL, hematokrit %20.6, trombosit sayısı 519 bin/uL olarak bulundu. Hastanın retikülositi % 2.14 direktve indirekt Coomb’s testi pozitif bulundu. Soğuk agglutinin titrasyon testi 1/2016, kriyoglobulin ve kriyofibrinojen negatif bulundu. Mycoplasma pneumoniae (M. pneumoniae) IgM1.33 (pozitif), M. pneumoniae IgG 0.38 (negatif), EBV - VCA IgM: 0.62 (negatif), EBV - VCAIgG: 196 (pozitif) bulundu. Hasta klinik olarak izlendi. Ek bir tedavi verilmeden hasta levofloksasin tedavisi ile taburcu edildi. İzleminde hemoliz krizi yine gözlenmedi.
A 14-year-old female patient presented with a 3-day history of high fever and cough. It was_x000D_ learnt that she had started to use oseltamivir after her complaints started. Physical examination revealed decreased breath sounds in the lower and middle zones of the left lung and_x000D_ crepitant rales in the right lung. Some laboratory examination test results were as follows:_x000D_ hemoglobin 10.6 g/dL, hematocrit 33.5%, MCV 76.5 fL, white blood cell count 5.97x103 /_x000D_ uL, platelet count 180x103 /uL, CRP 205.6 mg/L, procalcitonin 1.28 ng/mL. Posteroanterior_x000D_ (PA) chest X-ray showed consolidation in the middle and lower zones of the left lung and_x000D_ infiltration in the lower zone of the right lung. Treatment with ceftriaxone, clarithromycin_x000D_ and teicoplanin was started. On the third day of treatment, their body temperatures fell_x000D_ and her general condition improved. On the 10th day of clinical follow-up, chest X-ray findings improved significantly, In control tests hemoglobin (10.8 g/dL), hematocrit (20.6%),_x000D_ platelet count (519x103 /uL), and reticulocyte count (2.14%), were also evaluated. Direct_x000D_ and indirect Coomb’s tests yielded positive results. The results of some tests perfomed were_x000D_ as follows: Cold agglutinin titration test (1/2016), Cryoglobulin negative, Cryofibrinogen_x000D_ negative. Mycoplasma pneumoniae (M. pneumoniae) IgM 1.33 (positive), M. pneumoniae_x000D_ IgG 0.38 (negative), EBV - VCA IgM: 0.62 (negative), EBV - VCA IgG: 196 (positive). She was_x000D_ discharged with levofloxacin treatment without any additional treatment. Hemolysis crisis_x000D_ was not observed during the follow-up.
A 14-year-old female patient presented with a 3-day history of high fever and cough. It was_x000D_ learnt that she had started to use oseltamivir after her complaints started. Physical examination revealed decreased breath sounds in the lower and middle zones of the left lung and_x000D_ crepitant rales in the right lung. Some laboratory examination test results were as follows:_x000D_ hemoglobin 10.6 g/dL, hematocrit 33.5%, MCV 76.5 fL, white blood cell count 5.97x103 /_x000D_ uL, platelet count 180x103 /uL, CRP 205.6 mg/L, procalcitonin 1.28 ng/mL. Posteroanterior_x000D_ (PA) chest X-ray showed consolidation in the middle and lower zones of the left lung and_x000D_ infiltration in the lower zone of the right lung. Treatment with ceftriaxone, clarithromycin_x000D_ and teicoplanin was started. On the third day of treatment, their body temperatures fell_x000D_ and her general condition improved. On the 10th day of clinical follow-up, chest X-ray findings improved significantly, In control tests hemoglobin (10.8 g/dL), hematocrit (20.6%),_x000D_ platelet count (519x103 /uL), and reticulocyte count (2.14%), were also evaluated. Direct_x000D_ and indirect Coomb’s tests yielded positive results. The results of some tests perfomed were_x000D_ as follows: Cold agglutinin titration test (1/2016), Cryoglobulin negative, Cryofibrinogen_x000D_ negative. Mycoplasma pneumoniae (M. pneumoniae) IgM 1.33 (positive), M. pneumoniae_x000D_ IgG 0.38 (negative), EBV - VCA IgM: 0.62 (negative), EBV - VCA IgG: 196 (positive). She was_x000D_ discharged with levofloxacin treatment without any additional treatment. Hemolysis crisis_x000D_ was not observed during the follow-up.