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증례 : 감염 ; 신장 경색을 동반한 Streptococcus agalactiae 감염 심내막염 1예
김주일 ( Joo Il Kim ),조현정 ( Hyon Joung Cho ),서종구 ( Jong Goo Seo ),김진용 ( Jin Yong Kim ),박윤수 ( Yoon Soo Park ),서일혜 ( Yiel Hae Seo ),조용균 ( Yong Kyun Cho ) 대한내과학회 2009 대한내과학회지 Vol.77 No.5S
저자들은 별다른 기저 질환이 없던 건강한 성인 남성이 GBS에 의한 신장경색이 동반된 감염 심내막염을 최초로 경험하였기에 문헌고찰과 함께 보고한다. 최근 GBS에 의한 침습적 감염이 당뇨병이나 악성 종양 및 간경화와 같은 만성 기저질환이나 고령과 연관하여 증가하고 있다. 하지만 이와 같은 위험인자가 없는 환자에서도 GBS에 의한 감염이 발생할 수 있으며 GBS 감염 심내막염은 신장 경색을 포함한 전신적 색전증이나 다른 합병증이 빈번하게 발생하여 예후가 좋지 않을 수 있기 때문에 조기에 수술을 포함한 적극적으로 치료를 고려하여야 한다. Group B streptococcus (GBS, Streptococcus agalactiae) is categorized as a Lancefield Group B beta-hemolytic streptococci. GBS is a recognized cause of sepsis and meningitis in newborns and pregnant women. However, the incidence of GBS disease in nonpregnant adults is increasing, particularly in the elderly and those with significant underlying diseases. GBS infective endocarditis is generally characterized by an acute onset, the presence of large vegetations, rapid valvular destruction, and the frequent development of complications. Here we report the first case of GBS infective endocarditis associated with kidney infarction. (Korean J Med 77:S1328-S1331, 2009)
증례 : 신장 ; 복막투석 환자에서 발생한 Tsukamurella tyrosinosolvens 복막염 1예
박재찬 ( Jae Chan Park ),홍준식 ( Jun Shik Hong ),서종구 ( Jong Goo Seo ),정우경 ( Woo Kyung Chung ),서일혜 ( Yiel Hae Seo ),이현희 ( Hyun Hee Lee ) 대한내과학회 2009 대한내과학회지 Vol.76 No.2
복막염은 지속적 외래 복막투석 환자에서 가장 흔한 감염성 합병증이다. Tsukamurella속에 의한 복막염은 외국에 2예의 보고가 있었으나 국내에는 아직 보고된 증례가 없기에 문헌고찰과 함께 저자들이 경험한 증례를 보고하는 바이다. Tsukamurella속은 정확한 균주의 동정이 어렵고 고식적인 항균제 치료에 반응을 보이지 않기 때문에 난치성 복막염에서 항산성의 균이 관찰되거나 그람 양성 간균이 반복적으로 동정되었을 때 Tsukamurella속을 원인 균으로서 생각해 보아야 하며 근절을 위해서는 복막 투석용 도관의 제거를 고려하여야 한다. A case of Tsukamurella peritonitis associated with continuous ambulatory peritoneal dialysis (CAPD) in a 54-year-old woman is described. Peritonitis is a common complication of peritoneal dialysis in patients with end-stage renal disease. Tsukamurella has been reported to cause rare opportunistic infections in humans, and most cases have been reported in immunocompromised patients or patients with indwelling foreign bodies. This organism is difficult to identify and has been mistaken for Corynebacterium and atypical Mycobacteria. Here, we describe the first case of CAPD-related peritonitis caused by Tsukamurella tyrosinosolvens in Korea. It was treated with CAPD catheter removal. (Korean J Med 76:225-228, 2009)
서종구,박재찬,안홍대,이서영,김진용,박윤수,조용균 대한감염학회 2008 감염과 화학요법 Vol.40 No.6
Klebsiella pneumoniae is a pathogen that causes a wide range of infections in human, and has a tendency to metastasize to multiple organs. We report two rare cases of K. pneumoniae infection that have spread to multiple organs without being accompanied by liver abscess. A 59-year-o1d man (case 1) was admitted due to left knee pain. Microbiologic and radiologic studies revealed bacteremia, septic arthritis, pneumonia, Prostatitis, and endophthalmitis caused by K. pneumoniae. A 48-year-o1d man (case 2) was admitted due to febrile sensation. Microbiologic and radiologic studies revealed bacteremia, pneumonia, urinary tract infection, endophthalmitis, and cerebritis caused by K. pneumoniae. With appropriate use of effective antibiotics and therapeutic measures, the patients recovered but with some sequelae.
Streptococcus constellatus에 의한 경막 외 농양이 동반된 화농성 척추염 1예
안홍대,박재찬,서종구,김진용,김수연,박윤수,서일혜,조용균 대한감염학회 2008 감염과 화학요법 Vol.40 No.5
We report a case of vertebral osteomyelitis with epidural abscess caused by Streptococcus constellatus. The patient was present with fever, back pain, and dyspnea for 1 week. The patient was previously healthy and did not have any predisposing factor. After evaluation, the patient was diagnosed as Streptococcus constellatus vertebral osteomyelitis. He was successfully treated with surgical debridement and antibiotic therapy. To the best of our knowledge, this is the first case of S. constellatus vertebral osteomveltis with epidural abscess to be reported in Korea.
원인식,박예민,조현정,김형수,서종구,김진용,남동흔,박윤수,서일혜,조용균 대한감염학회 2009 감염과 화학요법 Vol.41 No.4
Syphilis is re-emerging worldwide due to the HIV epidemic. Prior to the introduction of penicillin, syphilis was the second most common primary cause of all cases of uveitis. Today, ocular syphilis is a rare disease, especially in an immunocompetent patient. Variable manifestation without pathognomonic signs of ocular syphilis often lead to delayed diagnosis, resulted in irreversibile loss of vision. In Korea, syphilitic uveitis has not been reported in an immunocompetent patient since 1984. We experienced a case of syphilitic uveitis in an immunocompetent man with visual deterioration. As the incidence of syphilis is increasing in these days, a high degree of clinical suspicion should be considered in patients with unexplained ocular inflammation and visual disturbances.
박예민,원인식,김주일,조현정,서종구,김진용,김은영,박상희,박윤수,서일혜,조용균 대한감염학회 2009 감염과 화학요법 Vol.41 No.4
Actinomyces normally colonizes the mouth, colon, and vagina. Although disruption of mucosa may lead to infection at virtually any site, central nervous system actinomycosis is rare. A 45-year-old man presented with seizure and magnetic resonance imaging showed brain abscess. He was diagnosed with actinomycotic and streptococcal infection of brain by histologic and microbiologic examination. After stereotactic aspiration and biopsy, he was treated successfully by prolonged antibiotic therapy using intravenous penicillin-G and oral amoxicillin.
성인에서 Mycoplasma pneumoniae 페렴과 동반된 Stevens-Johnson 증후군 1예
이정현,엄영실,한우진,윤규현,이서영,서종구,김진용,김수연,박윤수,서일혜,조용균 대한감염학회 2008 감염과 화학요법 Vol.40 No.6
Stevens-Johnson syndrome is an acute mucocutaneous syndrome that is related to drugs and infections. Mycoplasma pneumonias infection is known as one of the causes of Stevens-Johnson syndrome in children and young adults, In Korea, Mycoplasma pneumoniae infection is rarely reported as a cause of Stevens-Johnson syndrome in adults. We report a case of Stevens-Johnson syndrome associated with Mycoplasma pneumoniae pneumonia in an adult patient. A 34-years old woman was admitted to our hospital and was diagnosed with mycoplasma pneumonia. At the time of admission, she had hemorrhagic crusts on her lips. On the 2nd day of admission, target lesions also developed on her skin. We diagnosed her disease as Stevens-Johnson syndrome associated with Mycoplasma pneumoniae pneumonia. She completely recovered from pneumonia and Stevens-Johnson syndrome after treatment with antibiotics and conservative management.