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중증 열성혈소판감소증후군 환자에서 혈장교환술 치료 중 발생한 치명적 폐손상
오현주 ( Hyunjoo Oh ),유정래 ( Jeong Rae Yoo ),성길명 ( Gil Myeong Seong ),김선형 ( Sun Hyung Kim ),허상택 ( Sang Taek Heo ) 대한내과학회 2020 대한내과학회지 Vol.95 No.3
Severe fever with thrombocytopenia syndrome (SFTS) caused by the SFTS virus (SFTSV), a novel Phlebovirus, is endemic to South Korea, central and northeastern China, and western Japan. SFTS poses a threat to public health because of its high mortality and secondary transmission. Ticks and domestic animals are hosts for SFTSV in endemic areas. There is no specific treatment for SFTS, and avoiding tick bites is the best way to prevent infection. Early therapeutic plasma exchange (TPE) is a rescue therapy in patients with rapidly progressive SFTS. Here, we present a patient with SFTS who was improving on TPE but died suddenly due to acute lung injury after TPE. (Korean J Med 2020;95:211-215)
김성택 ( Seong Taeg Kim ),조재민 ( Jaemin Jo ),유정래 ( Jeong Rae Yoo ),김미연 ( Miyeon Kim ),한경희 ( Kyoung Hee Han ),김정호 ( Jung Ho Kim ),한상훈 ( Sang Hoon Han ) 대한내과학회 2017 대한내과학회지 Vol.92 No.1
말초형 T세포 림프종은, 림프절외 증상이 비특이적으로 나타날 경우 질병이 진행하기 전까지 진단이 어려울 수 있다. 본 증례는 T세포 림프종에 의한 림프절 종대의 빠른 진행과 함께 드문 합병증인 유미흉으로 발현한 환자이며 비특정 말초 T세포 림프종으로 확진된 1예로 호흡곤란을 유발하는 유미흉을 적절히 조절하여, 항암화학요법을 속히 시행하고 부분반응을 얻을 수 있었던 증례이다. A 72-year-old male presented with respiratory discomfort. A simple chest X-ray and abdominal computed tomography showed pleural effusion and multiple lymph node enlargement. The pleural effusion was determined by thoracentesis to be chylothorax. An inguinal lymph node biopsy showed peripheral T-cell lymphoma. Following three cycles of cyclophospamide, hydroxyl doxorubicin, vincristine, prednisolone (CHOP) chemotherapy, a partial response was observed. Chylothorax is an extremely rare complication of T-cell lymphoma. We present a case of peripheral T-cell lymphoma presenting with chylothorax. We suggest that clinicians should consider chylothorax when examining patients with lymphoma who present with atypical pleural effusion. (Korean J Med 2017;92:74-78)
건강한 성인에서 발생한 Mycobacterium massiliense 중이염
김미연 ( Miyeon Kim ),허상택 ( Sang Taek Heo ),이재근 ( Jae-geun Lee ),서지영 ( Michelle J. Suh ),현창림 ( Chang Lim Hyun ),유정래 ( Jeong Rae Yoo ) 대한내과학회 2020 대한내과학회지 Vol.95 No.4
Mycobacterium massiliense (M. massiliense) is a novel nontuberculous mycobacteria (NTM) and an opportunistic pathogen that lives in the water, soil, food, and air. It is a subspecies of the rapidly growing mycobacteria Mycobacterium abscessus. This atypical pathogen has been reported mainly in patients with lung disease or those undergoing cosmetic or surgical procedures. A 62-year-old woman presented with productive otorrhea for 10 months, no history of surgery, and chronic otitis media. M. massiliense was identified from a tissue specimen using real-time polymerase chain reaction for NTM (Biosewoom, Seoul, Korea), and NTM was identified by acid-fast bacilli culture. Successful treatment consisted of clarithromycin for 4 months. No other case of chronic otitis media related to M. massiliense has been reported. This is the first confirmed case of chronic otitis media caused by M. massiliense in a healthy adult in South Korea. (Korean J Med 2020;95:276-280)
증례 : 감염 ; HIV 감염 환자에서 피부의 좁쌀결핵으로 발현한 IRIS 1예
고재훈 ( Jae Hoon Ko ),신범수 ( Beom Su Shin ),이성수 ( Seong Soo Lee ),임경숙 ( Kyung Suk Lim ),이우주 ( Woo Joo Lee ),유정래 ( Jeong Rae Yoo ),강철인 ( Cheol In Kang ) 대한내과학회 2014 대한내과학회지 Vol.86 No.5
피부의 좁쌀결핵은 면역저하 상태에서 발생하는 결핵의 드문 감염형태로, 구진 농포성 발진과 피부를 포함한 여러 장기로의 결핵균의 혈행성 다장기 감염을 특징으로 한다. 저자들은 ART를 시작한 HIV 감염 환자에서 피부의 좁쌀결핵으로 발현한 IRIS 첫 예를 경험하여 이를 보고하는 바이다. Tuberculosis is one of the most common opportunistic diseases in human immunodeficiency virus (HIV)-infected patients in Korea, and extra-pulmonary infections are frequent in these patients. Cutaneous miliary tuberculosis is a rare form of tuberculosis that presents as a papulopustular eruption and hematogenous dissemination of Mycobacterium tuberculosis to multiple organs. This has been reported in patients with progressive HIV infection. We report the first case of cutaneous miliary tuberculosis that developed as a manifestation of immune reconstitution inflammatory syndrome (IRIS) after initiating antiretroviral therapy (ART). (Korean J Med 2014;86:647-650)