Epstein-Barr Vir\u00fcs\u00fcn\u00fcn (EBV) etken oldu\u011fu, en fazla \u00e7ocuklarda ve gen\u00e7 eri\u015fkinlerde g\u00f6r\u00fclen; ate\u015f, lenf bezi b\u00fcy\u00fcmesi, bo\u011faz a\u011fr\u0131s\u0131 veya anjin ile seyreden bir hastal\u0131kt\u0131r. Monositer Anjin, Gland\u00fcler Ate\u015f gibi isimleri de vard\u0131r. \u0130nfeksiy\u00f6z monon\u00fckleoz insandan insana t\u00fck\u00fcr\u00fck salg\u0131s\u0131yla, en \u00e7ok \u00f6p\u00fc\u015fme gibi yak\u0131n temasla bula\u015f\u0131r. Hastal\u0131\u011f\u0131n aktif d\u00f6neminde bula\u015ft\u0131rma olas\u0131l\u0131\u011f\u0131 y\u00fcksektir. Ayr\u0131ca kan ve kan \u00fcr\u00fcnlerinin verilmesi ile de ba\u015fkalar\u0131na bula\u015fabilir. EBV ile olu\u015fan bu t\u00fcr hastal\u0131klar t\u00fcm d\u00fcnyada yayg\u0131n olarak g\u00f6r\u00fclmektedir. K\u00fc\u00e7\u00fck ya\u015flarda genellikle daha hafif seyreder, ya\u015f ilerledik\u00e7e \u00f6zellikle 15-25 ya\u015f grubunda belirtiler daha belirgindir. Vir\u00fcs\u00fcn v\u00fccuda girmesinden sonra \u00e7ocuklarda 10-14 g\u00fcn, eri\u015fkinlerde 30-50 g\u00fcn i\u00e7inde hastal\u0131k olu\u015fmaktad\u0131r. Genellikle ba\u015flang\u0131\u00e7ta 3-5 g\u00fcn s\u00fcren hafif ba\u015f a\u011fr\u0131s\u0131, halsizlik, \u00fc\u015f\u00fcme, titreme, terleme, ate\u015f basmas\u0131, bulant\u0131 gibi yak\u0131nmalar vard\u0131r. Sonras\u0131nda \u015fiddetli bo\u011faz a\u011fr\u0131s\u0131, d\u00fc\u015fmeyen ate\u015f ve lenf bezi b\u00fcy\u00fckl\u00fc\u011f\u00fc, ayr\u0131ca kas a\u011fr\u0131s\u0131, g\u00f6z arkas\u0131nda a\u011fr\u0131, \u00f6ks\u00fcr\u00fck, kar\u0131nda rahats\u0131zl\u0131k hissi olu\u015fur. Hastalarda daha \u00e7ok \u00f6\u011fleden sonra ve ak\u015fam y\u00fckselen 38-39 \u00b0C\u2019ye hatta bazen 40 \u00b0C\u2019ye \u00e7\u0131kan ate\u015f vard\u0131r. 10 g\u00fcn kadar devam edebilir. Hastal\u0131k ge\u00e7irilince ba\u011f\u0131\u015f\u0131kl\u0131k olu\u015fur. Eri\u015fkin ya\u015f gurubunda ba\u011f\u0131\u015f\u0131kl\u0131k bir\u00e7ok \u00fclkede %90-95\u2019dir. Genel olarak toplumda g\u00f6r\u00fclme s\u0131kl\u0131\u011f\u0131 mevsimlere g\u00f6re fazla de\u011fi\u015fiklik g\u00f6stermez. Ancak \u00f6\u011frenciler aras\u0131nda yap\u0131lan \u00e7al\u0131\u015fmalarda ilkbahar ve sonbaharda daha fazla g\u00f6r\u00fcld\u00fc\u011f\u00fc saptanm\u0131\u015ft\u0131r. Belirtiler ve Bulgular Yutakta k\u0131zar\u0131kl\u0131k ve \u015fi\u015flik yan\u0131nda, bo\u011fazda bademciklerde gri-beyaz tabakal\u0131 iltihap, hastalar\u0131n hemen hemen yar\u0131s\u0131nda g\u00f6r\u00fcl\u00fcr. Ate\u015f, bo\u011faz a\u011fr\u0131s\u0131 ve anjin 7-10 g\u00fcn kadar s\u00fcrer. Hastalar\u0131n bir k\u0131sm\u0131nda yumu\u015fak ve sert damak birle\u015fim yerinde 1-2 mm \u00e7ap\u0131nda say\u0131lar\u0131 5-20 aras\u0131nda de\u011fi\u015fen k\u0131zar\u0131kl\u0131klar vard\u0131r. \u00d6p\u00fcc\u00fck hastal\u0131\u011f\u0131nda en \u00f6nemli bulgu boyunda iki tarafta lenf bezlerindeki a\u015f\u0131r\u0131 b\u00fcy\u00fcmedir. En fazla boyunda g\u00f6r\u00fclmekle birlikte \u00e7ene alt\u0131nda, koltuk alt\u0131, kas\u0131k, g\u00f6\u011f\u00fcs ve kar\u0131n i\u00e7inde de lenf bezleri b\u00fcy\u00fcyebilir. Tek veya birden fazla, sert, dokunmakla a\u011fr\u0131l\u0131, birbirine yap\u0131\u015f\u0131k olmayan 2-3 cm. boyutunda lenf bezi b\u00fcy\u00fckl\u00fckleri \u015feklindedir. Lenf bezlerinin k\u00fc\u00e7\u00fclerek kaybolmalar\u0131 birka\u00e7 hafta s\u00fcrebilir. Hastalar\u0131n akci\u011fer ve kalp muayene bulgular\u0131 normaldir; yar\u0131s\u0131nda dalakta, on ki\u015fiden birinde karaci\u011ferde b\u00fcy\u00fcme bulunur. Daha az olas\u0131l\u0131kla sar\u0131l\u0131k da olabilir. Sar\u0131l\u0131k veya karaci\u011fer b\u00fcy\u00fckl\u00fc\u011f\u00fc olsun ya da olmas\u0131n, hemen hemen t\u00fcm hastalarda karaci\u011fer testleri birka\u00e7 hafta s\u00fcreyle y\u00fckselmi\u015f olarak bulunur. Hastalar\u0131n bir k\u0131sm\u0131nda g\u00f6vdede kol ve bacaklarda k\u0131rm\u0131z\u0131 d\u00f6k\u00fcnt\u00fcler olabilir. Ampisilin i\u00e7eren antibiyotik verilirse, yayg\u0131n cilt d\u00f6k\u00fcnt\u00fcs\u00fc olmakta ve ilac\u0131 kesince ge\u00e7mektedir. \u00d6p\u00fcc\u00fck Hastal\u0131\u011f\u0131nda Laboratuvar Tetkikleri Akyuvarlar\u0131n say\u0131s\u0131 ve tiplerinin belirlenmesi \u0130nfeksiy\u00f6z monon\u00fckleoz d\u00fc\u015f\u00fcn\u00fclen bir hastada ilk yap\u0131lmas\u0131 gereken laboratuvar incelemeleri kanda akyuvarlar\u0131n say\u0131s\u0131 ve tiplerinin belirlenmesidir. Hastal\u0131\u011f\u0131n erken d\u00f6neminde akyuvarlar normal olabilirken, ikinci-\u00fc\u00e7\u00fcnc\u00fc haftalarda artmaktad\u0131r. Akyuvarlar\u0131n bir k\u0131sm\u0131 atipik lenfosit denen h\u00fccrelere d\u00f6n\u00fc\u015f\u00fcr. Bunlar daha b\u00fcy\u00fck, \u00e7ekirdekleri par\u00e7al\u0131 veya \u00e7entikli h\u00fccrelerdir. Atipik lenfositler infeksiy\u00f6z monon\u00fckleoz yan\u0131nda, k\u0131zam\u0131k\u00e7\u0131k, kabakulak, gibi di\u011fer di\u011fer baz\u0131 vir\u00fcs hastal\u0131klar\u0131nda da g\u00f6r\u00fclebilir, ancak bu hastal\u0131klarda ancak say\u0131lar\u0131 \u00e7ok daha azd\u0131r. \u0130nfeksiy\u00f6z monon\u00fckleoz tan\u0131s\u0131nda gereken hastalarda Paul- Bunnel testi, Monotest, antikorlar\u0131n tespiti ve karaci\u011fer fonksiyon testleri yap\u0131labilir.<\/p>\n
Ay\u0131r\u0131c\u0131 Tan\u0131 \u0130nfeksiy\u00f6z monon\u00fckleozlu hastalar\u0131n \u00e7o\u011funda muayene bulgular\u0131 yan\u0131nda, atipik lenfositler, Paul- Bunnel testi ve monotest pozitifli\u011fi tan\u0131y\u0131 koydurur. Adenovir\u00fcsler ve beta mikrobu ile olu\u015fan hastal\u0131klar\u0131ndan ilave tetkik ve k\u00fclt\u00fcrler yap\u0131larak ay\u0131rt edilmelidir. Komplikasyonlar \u0130nfeksiy\u00f6z monon\u00fckleozda nadir de olsa Zat\u00fcrre ve Sepsis denilen mikrobun kana ge\u00e7mesi durumu ve bir kans\u0131zl\u0131k hastal\u0131\u011f\u0131 olan Otoimm\u00fcn Hemolitik anemi gibi hastal\u0131klar olu\u015fabilir. \u00c7ok nadiren Trombositopeni denen kan p\u0131ht\u0131la\u015fma h\u00fccrelerinde azalma sonucu beyin kanamas\u0131 ve \u00f6l\u00fcme yol a\u00e7abilir. Bu durumda hemen steroidler uygulan\u0131r. Baz\u0131 infeksiy\u00f6z monon\u00fckleozlu hastalarda bademciklerin ve yutaktaki lenf dokular\u0131n\u0131n a\u015f\u0131r\u0131 \u015fi\u015fli\u011fine ba\u011fl\u0131 \u00fcst solunum yolu t\u0131kan\u0131kl\u0131\u011f\u0131 geli\u015febilir. \u00c7ok nadiren dalak par\u00e7alanmas\u0131 olu\u015fabilir. Acil kan verilmesi ve dala\u011f\u0131n acilen ameliyatla al\u0131nmas\u0131 gerekebilir. Klinik Seyir ve Prognoz \u00d6l\u00fcm \u00e7ok nadiren, n\u00f6rolojik komplikasyonlar, Splenik R\u00fcpt\u00fcr, \u00fcst solunum yolu obstr\u00fcksiyonuna ba\u011fl\u0131 olarak g\u00f6r\u00fcl\u00fcr. \u0130nfeksiy\u00f6z monon\u00fckleozun a\u011f\u0131r seyretti\u011fi Duncan tipi X’e ba\u011fl\u0131 Resesif \u0130mm\u00fcn yetmezliklerde infeksiyonun akut d\u00f6neminde \u00f6l\u00fcm g\u00f6r\u00fclebilir veya birka\u00e7 y\u0131l i\u00e7inde Agamaglobulinemi ve Lenfoma geli\u015febilir. Kronik veya Persistan EBV \u0130nfeksiyonu Persistan EBV infeksiyonunun, gen\u00e7 ve orta ya\u015fl\u0131 eri\u015fkinlerdeki halsizlik, yorgunluk ve di\u011fer bir\u00e7ok belirtiyle kendini g\u00f6steren kronik yorgunluk sendromu ile ili\u015fkili olabilece\u011fi d\u00fc\u015f\u00fcn\u00fclm\u00fc\u015ft\u00fcr. Fakat serolojik ve epidemiyolojik ara\u015ft\u0131rmalar EBV infeksiyonunun bu sendromun olu\u015fumundaki etiyolojik rol\u00fcn\u00fcn ancak, di\u011fer mikroorganizmalar kadar olabilece\u011fini g\u00f6stermi\u015ftir. Tedavi \u0130nfeksiy\u00f6z monon\u00fckleozlu hastalar\u0131n \u00e7o\u011fu 2-3 haftada iyile\u015fir. Tedavi b\u00fcy\u00fck \u00f6l\u00e7\u00fcde destekleyici tedavidir. Hastal\u0131\u011f\u0131n aktif d\u00f6neminde yatak istirahati gereklidir. Aspirin ve benzeri ila\u00e7lar ate\u015f ve bo\u011faz a\u011fr\u0131s\u0131 i\u00e7in verilir. \u0130leri solunum yolu t\u0131kan\u0131kl\u0131\u011f\u0131, p\u0131ht\u0131la\u015fma bozuklu\u011fu, kans\u0131zl\u0131k gibi baz\u0131 a\u011f\u0131r komplikasyonlarda kortizon \u00f6nerilmektedir. Vir\u00fcslere etkili ila\u00e7larla tedavi baz\u0131 olgularda denenmi\u015ftir. Ancak iyile\u015fmeye \u00e7ok az etkisi oldu\u011fu g\u00f6zlenmi\u015ftir<\/p>\n
<\/p>\n","protected":false},"excerpt":{"rendered":"
\u00d6p\u00fcc\u00fck hastal\u0131\u011f\u0131 (infeksiy\u00f6z monon\u00fckleoz) Konu hakk\u0131nda detayl\u0131 ve g\u00fcncel bilgiler i\u00e7in bu makaleyi okuyun<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18],"tags":[281,142,45,85,37],"class_list":["post-1103","post","type-post","status-publish","format-standard","hentry","category-kulak-burun-bogaz","tag-ates","tag-bogaz","tag-gun","tag-kan","tag-yas"],"_links":{"self":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/1103","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/comments?post=1103"}],"version-history":[{"count":1,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/1103\/revisions"}],"predecessor-version":[{"id":1104,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/1103\/revisions\/1104"}],"wp:attachment":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/media?parent=1103"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/categories?post=1103"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/tags?post=1103"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}