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Kyung Hye Keum(금경혜),Kye Hyang Lee(이계향) 대한소아신경학회 2008 대한소아신경학회지 Vol.16 No.2
5세 남아가 갑작스런 시력저하를 주소로 내원하였다. 환아는 내원 6주전부터 두통 및 전반적인 무력감을 호소하였고 1주일 전부터 양측 안구 통증을 호소하였다. 호흡기 증상은 선행하거나 동반되지 않았다. 안과 검진상 양측 시신경염 소견을 보였고, 피부에는 소양성 자반 병변이 관찰되었다. 뇌 자기공명영상술상 급성 파종성 뇌척수염에 합당한 뇌백색질의 병변이 보였고, 혈청학적 검사상 M. pneumoniae에 양성이었다. 환아는 고용량의 정맥내 스테로이드와 경구용 clarithromycin으로 치료 후 완전히 회복되었다. 저자들은 M. pneumoniae에 의한 전신 증상 이후 아급성으로 발생한 면역 매개성 기전에 의한 신경계 및 피부의 폐외 증상이 동시에 발현하여 면역억제제와 경구용 항생제 치료로 회복된 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Mycoplasma pneumoniae(M. pneumoniae) is a well-known human respiratory pathogen. It also affects various organ systems and causes extrapulmonary complications, including neurologic, cutaneous, hematologic and ophthalmologic complications. M. pneumoniae has been implicated in a number of immune-mediated neurological diseases, such as ADEM, Gullian-Barré syndrome, and transverse myelitis. We present a 5-year-old boy with bilateral optic neuritis related to ADEM and pruritic skin lesions simultaneously associated with M. pneumoniae infection. He developed a headache with decreased activity six weeks before admission. He had no respiratory symptoms. Cerebral MRI showed multiple bilateral subcortical white matter lesions, suggesting a radiologic diagnosis of ADEM. M. pneumoniae was positive serologically. The cerebrospinal fluid polymerase chain reaction for M. pneumoniae was negative. The treatment with intravenous high-dose steroids and oral clarithromycin resulted in the rapid recovery of the patients visual and cutaneous problems. He was found to have returned to his normal conditions in the follow-up examination. We believe that immune-mediated injury can explain all the clinical manifestations of our case, which are ADEM-associated optic neuritis and cutaneous lesions.
신생아 위액에서 발견된 Balantidium coli 1례
금경혜 ( Kyung Hye Keum ),서민애 ( Min Ae Suh ),박혜진 ( Hye Jin Park ),이계향 ( Kye Hyang Lee ),이경훈 ( Gyeong Hoon Lee ),최은진 ( Eun Jin Choi ),김진경 ( Jin Kyung Kim ),정혜리 ( Hai Lee Chung ),김우택 ( Woo Taek Kim ) 대한주산의학회 2008 Perinatology Vol.19 No.1
Balantidium coli is the only pathogenic ciliate parasitizing humans. Balantidium coli is widely distributed in hogs, particularly in warm and temperate climates, and in monkeys in the tropics. It is infrequently pathogenic for man. Balantidium coli is considered as a possible pathogen in immunocompromised patients. The infection fundamentally affects the colon and cause variable clinical pictures, from asymptomatic to serious dysenteric forms. Apart from intestinal involvement there have been reports on lung, liver, vagina infection by Balantidium coli. Balantidium coli were observed in the gastric juice of neonate. this is first report of asymptomatic balantidiasis in neonate.