Læknablaðið - 15.06.2007, Page 24

FRÆÐIGREIN / GEISLAGERLABÓLGA
geislagerlabólgu er til fjöldi heimilda um árang-
ursríka meðferð með erytrómýcíni, tetracýklínum
og klindamýcini (7). Skurðaðgerð eða hreinsun
á sýktum vef er talin vera mikilvægur þáttur í
meðferð (62) en þó er til fjöldi tilfellalýsinga þar
sem jafnvel útbreidd geislagerlabólga hefur verið
meðhöndluð með sýklalyfjum einvörðungu (7).
Lokaorð
I þessari grein segir frá konu sem fékk getn-
aðarvarnarlykkju uppsetta í kringum 1960 og
hafði ekki verið í reglubundnu eftirliti um langt
árabil. Af þessum sökum gleymdist lykkjan og var
því í leginu í ríflega fjóra áratugi. Klínísk mynd
okkar sjúklings er talsvert frábrugðin því sem lýst
hefur verið í læknaritum þar sem hún hafði hvorki
haft kviðverki, hita né fundið fyrir þyngdartapi
sem eru algengustu einkenni geislagerlabólgu í
grindarholi (51). Ekki var unnt að greina hvaða
tegund Actinomyces var hér á ferðinni. Þar sem
væg hækkun var á æxlisvísum var ekki hægt að
útiloka illkynja sjúkdóm. Þess fundust þó engin
merki við vefjarannsókn. Því er ljóst að bæta má
geislagerlabólgu á lista yfir góðkynja sjúkdóma
sem valdið geta hækkun á CA 125, CA 19-9 og
CEA. Þetta tilfelli minnir einnig á nauðsyn þess
að lykkjur séu fjarlægðar hjá konum sem komnar
eru yfir tíðahvörf. Síðast en ekki síst sýnir það
að árangur meðferðar er góður ef beitt er í senn
skurðaðgerð og lyfjameðferð.
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