pitanje
Profesore Jevtovicu, od maja meseca me setaju lekari jedan do drugog ne znajuci sta mi je. Pre nedelju dana mi je na klinici konstatovan Aspergilus fumigatus IgM 171,69 U/ml (pozitivan, referentno >70) i IgG 112,28 U/ml (pozitivno, referemtno > 70). Kasljem sve vreme, koristim foster pumpicu koju mi je dao pulmolog, osecam tremor po celom telu, blagu drhtavicu, imam bol u misicima nogu i ruku, zglobovima, a od pre par dana i u glavi i ocima. Za sada mi nisu dali nikakvu terapiju., temperaturu nemam. Da li trebalo da se primeni neka terapija i koja? Hvala Vam unapred za odgovor.
Đorđe Jevtović
Specijalista infektologije
plućna aspergiloza ima dva najčešća kliniča oblika, Evo iz udžbenika
1.Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to Aspergillus species (generally A. fumigatus) that occurs almost exclusively in patients with asthma or, less commonly, cystic fibrosis. Immune responses to Aspergillus antigens cause airway obstruction and, if untreated, bronchiectasis and pulmonary fibrosis. Symptoms and signs are those of asthma with the addition of productive cough and, occasionally, fever and anorexia. Diagnosis is suspected based on history and imaging tests and confirmed by Aspergillus skin testing and measurement of IgE levels, circulating precipitins, and A. fumigatus–specific antibodies. Treatment is with corticosteroids and, in patients with refractery disease, itraconazole
2. Aspergillosis is an opportunistic infection that usually affects the lower respiratory tract and is caused by inhaling spores of the filamentous fungus Aspergillus, commonly present in the environment. The spores germinate and develop into hyphae, which enter blood vessels and, with invasive disease, cause hemorrhagic necrosis and infarction. Symptoms may be those of asthma, pneumonia, sinusitis, or rapidly progressing systemic illness. Diagnosis is based on imaging, histopathology, and specimen staining and culture. Treatment is with voriconazole, posaconazole, or isavuconazonium. A lipid formulation of amphotericin B is an alternative treatment. Fungus balls may require surgical resection.
.Vaši respiratorni simptomi ponajviše ukazuju na prvi oblik, koji je nalik na astmu, a drugi nabrojani simptomi ne mogu da se povežu sa aspergilozom
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O lekaru
Prof. dr Đorđe Jevtović, rođen 1953. godine u Beogradu, lekar-infektolog. Profesor je Medicinskog fakulteta i načelnik centra za HIV na Klinici za infektologiju i tropske bolesti u Beogradu.
Oblasti medicine (Medicinska Ekspertiza):
- Zarazne bolesti
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