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증례 : 혈액종양 ; Micafungin을 투여받은 백혈병 환자에서 발생한 Trichosporon 감염증
손서영 ( Seo Young Sohn ),노정원 ( Jung Won Noh ),이가연 ( Ga Yeon Lee ),장복순 ( Bok Soon Chang ),김동환 ( Dong Hwan Kim ),장준호 ( Jun Ho Jang ),정철원 ( Chul Won Jung ) 대한내과학회 2009 대한내과학회지 Vol.77 No.5S
T. ashaii 감염증은 주로 혈액 종양 환자에서 항암 치료 후 발생하는 기회감염증으로 치명적인 경과를 취한다. 최근 호 중구 감소성 발열 환자에서 micafungin 사용 후 돌발성 T. ashaii 감염증이 보고된 바 있다. 생체 외 결과에서 T. ashaii는 azole 계통의 새로운 항진균제에 감수성이 있는 것으로 나타났으나 사람에서 발생한 감염증을 효과적으로 치료한 예는 드물다. 본 저자들은 voriconazole을 사용하여 성공적으로 T. ashaii 감염증을 치료한 1예를 경험하여 보고하는 바이다. Micafungin is a recently approved echinocandin with broad spectrum activity against Candida and Aspergillus species. However, this agent has limited activity against a number of fungi, including Trichosporon. We report a case of Trichosporon asahii fungemia in a 65 year old woman with acute myeloid leukemia that developed after 10 days of empirical micafungin therapy. Trichosporonosis was successfully treated with voriconazole and she achieved complete hematologic remission. After consolidation therapy, T. ashaii fungemia redeveloped, despite empirical amphotericin therapy for neutropenic fever. This was also controlled successfully with voriconazole. Because the use of micafungin is expected to increase, due to its effective antifungal activity, the possibility of breakthrough trichosporonosis should be considered in patients receiving micafungin. Voriconazole may be effective in controlling disseminated T. ashaii infection in neutropenic patients. (Korean J Med 77:S1318-S1322, 2009)
증례 : 호흡기 ; GM-CSF 흡입치료로 호전된 폐포단백증 1예
장복순 ( Bok Soon Chang ),노정원 ( Jung Won Noh ),옥창수 ( Chang Soo Ok ),이가연 ( Ga Yeon Lee ),손서영 ( Seo Young Sohn ),방선하 ( Sun Ha Bahng ),정만표 ( Man Pyo Chung ) 대한내과학회 2011 대한내과학회지 Vol.80 No.5
표준치료법인 전 폐하세척술에서 효과를 보지 못했던 폐포단백증 환자에서 GM-CSF 흡입법을 이용하여 임상적으로 증상, 폐기능, 흉부단층촬영에서 호전을 보인 증례를 보고하고자 한다. Pulmonary alveolar proteinosis (PAP) is a rare condition that is treated using whole lung lavage. A recent study suggested that granulocyte-macrophage colony stimulating factor (GM-CSF) plays roles in both the pathogenesis and treatment of PAP. We present a 69-year-old man with PAP who deteriorated despite bilateral whole lung lavage; that said, his symptoms, chest X-ray findings, and pulmonary function test improved after GM-CSF inhalation therapy over 12 months. GM-CSF therapy is an effective treatment modality for PAP.