{"id":6691,"date":"2020-07-30T00:54:24","date_gmt":"2020-07-29T21:54:24","guid":{"rendered":"http:\/\/blog.ulubat.org\/?p=6691"},"modified":"2021-01-07T14:32:04","modified_gmt":"2021-01-07T11:32:04","slug":"nadir-ama-tehlikeli-amip-cinsi-acanthamoeba-2","status":"publish","type":"post","link":"https:\/\/blog.ulubat.org\/index.php\/genel\/nadir-ama-tehlikeli-amip-cinsi-acanthamoeba-2\/","title":{"rendered":"Nadir ama Tehlikeli Amip Cinsi: Acanthamoeba"},"content":{"rendered":"\n

\u00c7ocuklardan ya\u015fl\u0131lara hemen hemen her ya\u015f grubunu enfekte eden bu canl\u0131, g\u00fcnl\u00fck hayat\u0131m\u0131zdan \u00e7ok uzakta ya\u015famamaktad\u0131r. Bu parazit lavabolardan, y\u00fczme havuzlar\u0131ndan, klimalardan ve i\u00e7me suyundan izole edilebilirken ayn\u0131 zamanda toprak gibi farkl\u0131 ya\u015fam alanlar\u0131nda da g\u00f6r\u00fclebilir.<\/p>\n\n\n\n

Acanthamoeba <\/em>keratiti patogenezinde rol alan bu organizma ciddi g\u00f6rme kay\u0131plar\u0131na ve hatta k\u00f6rl\u00fc\u011fe<\/em> neden olabilmektedir. Kona\u011f\u0131n kornea tabakas\u0131na yerle\u015fmesi ile d\u00fczensiz kornea epiteli  olu\u015fturmaya ba\u015flar. \u0130lerleyen s\u00fcre\u00e7lerde ise iltihapl\u0131 stromal \u00f6deme ve kornea \u00fclserine sebep olur. Hastan\u0131n durumuna ba\u011fl\u0131 olarak ila\u00e7 tedavisi veya cerrahi giri\u015fim uygulan\u0131r. Ya\u015fam d\u00f6ng\u00fcs\u00fcn\u00fcn trofozoit evresinde bulunan amipler tedaviye daha kolay yan\u0131t verirken kistler i\u00e7in durum farkl\u0131d\u0131r. Tedavi esnas\u0131nda kist formunda kalmalar\u0131 s\u00fcreci uzat\u0131r ve hastal\u0131\u011f\u0131n n\u00fcks etmesine neden olur.<\/p>\n\n\n\n

\"\"
(Acanthamoeba kist formu – Wikimedia Commons)<\/em><\/figcaption><\/figure><\/div>\n\n\n\n

Yayg\u0131n olarak tropik veya subtropikal iklimlerde g\u00f6r\u00fclen Acanthamoeba Keratiti <\/em>T\u00fcrkiye\u2019de de tespit edilmektedir. Bildirilen ilk vaka 70\u2019lerde ku\u015f \u00e7arpmas\u0131 sonucu geli\u015fmi\u015ftir. De\u011fi\u015fen hayat tarz\u0131yla beraber, travma sonucu geli\u015fen vakalar yerini b\u00fcy\u00fck \u00f6l\u00e7\u00fcde kontakt lens kullan\u0131m\u0131na b\u0131rakm\u0131\u015ft\u0131r. 2010\u2019da kontakt lens kullan\u0131m\u0131na ba\u011fl\u0131 vaka oran\u0131 %70 iken g\u00fcn\u00fcm\u00fczde bu say\u0131n\u0131n %80-%90 aras\u0131 oldu\u011fu tahmin edilmektedir. <\/p>\n\n\n\n

Genelde tek g\u00f6zde g\u00f6r\u00fclen k\u0131zar\u0131kl\u0131k, a\u011fr\u0131, \u0131\u015f\u0131\u011fa duyarl\u0131l\u0131k, bulan\u0131k g\u00f6rme, sulanma, batma belirtiler aras\u0131nda yer al\u0131r. Benzer durumlar s\u0131k g\u00f6zlemlendi\u011fi i\u00e7in te\u015fhisinde gecikme ya\u015fanmas\u0131 muhtemeldir. Antiviral, antibakteriyal ve antifungal ila\u00e7lar klinik tabloyu g\u00f6lgeleyebilir veya \u015fikayetleri ortadan kald\u0131rmayabilir. Tan\u0131 i\u00e7in kornea kaz\u0131nt\u0131 \u00f6rne\u011fi incelenir. Negatif \u00e7\u0131kan inceleme i\u00e7in kornea biyopsisi d\u00fc\u015f\u00fcn\u00fclebilir. Polimeraz Zincir Reaksiyonu (PCR)  ile genotip tespiti yap\u0131l\u0131r.<\/p>\n\n\n\n

Al\u0131n\u0131labilecek \u00d6nlemler:<\/p>\n\n\n\n

  1. Lens ile temas \u00f6ncesi ellerin y\u0131kan\u0131p kurulanmas\u0131, <\/li>
  2. Du\u015f ve y\u00fczme \u00f6ncesi lenslerin \u00e7\u0131kar\u0131lmas\u0131, <\/li>
  3. G\u00f6zde unutulmas\u0131 durumunda \u00e7\u00f6pe at\u0131lmas\u0131, <\/li>
  4. Lenslerin lens sol\u00fcsyonlarda saklanmas\u0131, <\/li>
  5. Hem lenslerin hem lens kaplar\u0131n\u0131n bu sol\u00fcsyon ile temizli\u011finin yap\u0131lmas\u0131, <\/li>
  6. Son kullanma tarihine dikkat edilmesi tavsiye edilir. <\/li><\/ol>\n\n\n\n
    \"\"
    (Acanthamoeba<\/em> ile kaplanm\u0131\u015f nekrotik beyin dokusunun MRI g\u00f6r\u00fcnt\u00fcs\u00fc \u2013 Wikimedia Commons)<\/figcaption><\/figure><\/div>\n\n\n\n

    Acanthamoeba’n\u0131n neden oldu\u011fu bir di\u011fer hastal\u0131k Gran\u00fclomat\u00f6z Amibik Ensefalittir(GAE). \u00d6l\u00fcmc\u00fcll\u00fck oran\u0131 %90\u2019dan fazla olan bu hastal\u0131k, imm\u00fcn sistem yetmezli\u011fi olan ki\u015filerde g\u00f6r\u00fclmektedir. D\u00fc\u015f\u00fck insidansl\u0131 oldu\u011fu gibi d\u00fc\u015f\u00fck prognuzu olan GAE te\u015fhisi genelde \u00f6l\u00fcm sonras\u0131 konmaktad\u0131r.<\/p>\n\n\n\n

    F\u0131rsat\u00e7\u0131 patojenin intravask\u00fcler bo\u015flu\u011fa ge\u00e7mesi alt solunum yollar\u0131 ve deri lezyonlar\u0131 arac\u0131\u011f\u0131yla oldu\u011fu belirlenmi\u015ftir. Ayr\u0131ca inhalasyon veya suyla temasta olfakt\u00f6r sinir ile direk beyne ge\u00e7ebilece\u011fi bulunmu\u015ftur. Mekanizmas\u0131 hen\u00fcz anla\u015f\u0131lamam\u0131\u015f hastal\u0131\u011f\u0131n kan-beyin bariyerini a\u015ft\u0131\u011f\u0131 bilinmektedir.<\/p>\n\n\n\n

    Belirtileri, davran\u0131\u015f de\u011fi\u015fikli\u011fi, ate\u015f, kusma, bulant\u0131, ba\u015f a\u011fr\u0131s\u0131, afazi, ataksi, tutuk boyun, n\u00f6bet, oryantasyon bozuklu\u011fu olabilir. Hastal\u0131\u011f\u0131n seyri fulminand\u0131r. Dikkat edilmesi gereken durum, imm\u00fcn sistemi yetersiz ki\u015filerde n\u00f6rolojik bozukluk olmas\u0131d\u0131r.<\/p>\n\n\n\n

    Te\u015fhisinde serebrospinal s\u0131v\u0131 incelenerek ilgili amip, nekrozlu beyin dokusu, lizise u\u011fram\u0131\u015f amip kal\u0131nt\u0131s\u0131 veya DNA`s\u0131 bulunabilir. PCR ile genotip belirlenir.<\/p>\n\n\n\n

    60\u2019l\u0131 y\u0131llardan beri incelen GAE i\u00e7in belirli bir tedavi protokol\u00fc bulunmamaktad\u0131r. Birka\u00e7 hastada olumlu sonu\u00e7lar\u0131n al\u0131nd\u0131\u011f\u0131 denenmi\u015f ila\u00e7lar mevcuttur. Konuyla ilgili \u00e7al\u0131\u015fmalar devam etmektedir.<\/p>\n\n\n\n

    <\/p>\n\n\n\n

    <\/p>\n\n\n\n

    <\/p>\n\n\n\n

    KAYNAK\u00c7A:<\/p>\n\n\n\n

    1. Mehmet Baykara, Ahmet T. \u00d6zmen, B\u00fclent Yaz\u0131c\u0131, A. Ali Y\u00fccel, Berkant Kaderli, \u00d6zg\u00fcr Yal\u00e7\u0131nbay\u0131r, Meral Y\u0131ld\u0131z, ve Berna A. Budak, G\u00d6Z ATLASI <\/em>Kapak, Kirpik, Konjonktiva, Kornea, Sklera, \u0130ris ve Pupilla, Lens, Kontakt Lens, Refraktif Cerrahi. <\/em>G\u00f6zya\u015f\u0131. Bursa: Bilim \u0130la\u00e7, 2013<\/li>
    2. P\u0131nar Ayd\u0131n O\u2019dwyer, ve Yonca Ayd\u0131n Akova. Temel G\u00f6z Hastal\u0131klar\u0131. Ankara: G\u00fcne\u015f T\u0131p Kitabevleri, 2010<\/li>
    3. Centers for Disease Control and Prevention. \u201d Parasites \u2014 Acanthamoeba \u2014 Granulomatous Amebic Encephalitis (GAE); Keratitis\u201d https:\/\/www.cdc.gov\/parasites\/acanthamoeba\/<\/a><\/li>
    4. University College London. “Eye infection in contact lens wearers can cause blindness.” ScienceDaily. https:\/\/www.sciencedaily.com\/releases\/2018\/09\/180921082952.htm<\/a>  Eri\u015fim: 18 Temmuz,  2020.<\/li>
    5. Society for General Microbiology. “Contact Lenses Are Home To Pathogenic Amoebae.” ScienceDaily. www.sciencedaily.com\/releases\/2008\/10\/081020093458.htm<\/a>  Eri\u015fim: 19 Temmuz , 2020.<\/li>
    6. Hatice Ertabaklar, Volkan Dayan\u0131r, P\u0131nar Apayd\u0131n, Sema Ertu\u011f, Julia Walochnik.\u201d Olgu Sunumu: Acanthamoeba Keratiti\u201d T\u00fcrkiye Parazitoloji Dergisi. 2009;33(4):283-285<\/li>
    7. Darly R. Pfister, J. Douglas Cameron, Jay H. Krachmer, Edward J. Holland.\u201d Confocal Microscopy Findings of Acanthamoeba Keratitis\u201d American Journal of Ophthalmology. 121,2, \u015eubat 1996, 119-128<\/li>
    8. Marciano-Cabral F, Cabral G. \u201cAcanthamoeba spp. As agents of disease in humans\u201d  Clin Microbiol Rev. 2003;16:273-307<\/li>
    9. Z\u00fcbeyde Ak\u0131npolat, Ay\u015fe Vural, Haydar Erdo\u011fan, G\u00fclandame Sayg\u0131n. \u201cAcanthamoeba Keratiti\u201d T\u00fcrkiye Klinikleri J Ophthalmol.2006;15(3):97-103<\/li>
    10. Matsui, T., Maeda, T., Kusakabe, S.\u201d A case report of granulomatous amoebic encephalitis by Group 1 Acanthamoeba genotype T18 diagnosed by the combination of morphological examination and genetic analysis\u201d Diagn Pathol 13, 27 (2018). https:\/\/doi.org\/10.1186\/s13000-018-0706-z<\/a><\/li>
    11. Sissons, J., Alsam, S., Goldsworthy, G.\u201dIdentification and properties of proteases from an Acanthamoeba isolate capable of producing granulomatous encephalitis\u201d BMC Microbiol 6, 42 (2006).  https:\/\/doi.org\/10.1186\/1471-2180-6-42<\/a><\/li>
    12. Geith, S., Walochnik, J., Prantl, F. \u201cLethal outcome of granulomatous acanthamoebic encephalitis in a man who was human immunodeficiency virus-positive: a case report\u201d J Med Case Reports 12, 201 (2018). https:\/\/doi.org\/10.1186\/s13256-018- HYPERLINK “https:\/\/doi.org\/10.1186\/s13256-018-1734-8″1734-8<\/a><\/li>
    13. Behera, H.S., Satpathy, G. & Tripathi, M. \u201cIsolation and genotyping of Acanthamoeba spp. from Acanthamoeba meningitis\/ meningoencephalitis (AME) patients in India\u201d Parasites Vectors 9, 442 (2016). https:\/\/doi.org\/10.1186\/s13071-016-1729-5<\/a><\/li>
    14. Wikimedia Commons.org \u201d Acanthamoeba spp (Cyst).jpg\u201d<\/li>
    15. Wikimedia Commons.org \u201cGranulomatous amoebic encephalitis.png\u201d<\/li>
    16. Siddiqui, R., Khan, N.A.\u201dBiology and pathogenesis of Acanthamoeba\u201d Parasites Vectors 5, 6 (2012). https:\/\/doi.org\/10.1186\/1756-3305-5-6 <\/a><\/li>
    17. Mortazavi, P.N., Goldsworthy, G., Kirk, R.\u201d Acanthamoeba produces disseminated infection in locusts and traverses the locust blood-brain barrier to invade the central nervous system\u201d  BMC Microbiol 10, 186 (2010). https:\/\/doi.org\/10.1186\/1471-2180-10-186<\/a><\/li><\/ol>\n\n\n\n

      <\/p>\n","protected":false},"excerpt":{"rendered":"

      \u00c7ocuklardan ya\u015fl\u0131lara hemen hemen her ya\u015f grubunu enfekte eden bu canl\u0131, g\u00fcnl\u00fck hayat\u0131m\u0131zdan \u00e7ok uzakta ya\u015famamaktad\u0131r. Bu parazit lavabolardan, y\u00fczme<\/p>\n","protected":false},"author":344,"featured_media":6696,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[1,25],"tags":[1687,70,274,725,1689,543,921,92,1691,1156,447,1155,727,1695,1693,1694,76,926,1654,1213,1214,283,1692,590,1688,1690,265,84,66],"acf":[],"views":1772,"_links":{"self":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/6691"}],"collection":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/users\/344"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/comments?post=6691"}],"version-history":[{"count":11,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/6691\/revisions"}],"predecessor-version":[{"id":9458,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/6691\/revisions\/9458"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media\/6696"}],"wp:attachment":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media?parent=6691"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/categories?post=6691"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/tags?post=6691"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}