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면역 저하 환자에서 발생한 파종성 Mycobacterium intracellulare 감염
김선영 ( Sun Young Kim ),오동욱 ( Dong Wook Oh ),유지희 ( Ji Hee Yu ),김동회 ( Dong Hoi Kim ),노세희 ( Se Hui Noh ),노재형 ( Jae Hyung Roh ),정상수 ( Sang Su Jung ),유동준 ( Dong Jun Yoo ),심태선 ( Tae Sun Shim ) 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.67 No.1
We report a case of disseminated Mycobacterium intracellulare infection in a 31-year-old man who had been diagnosed as having dermatomyositis and systemic lupus erythematosus 3-years prior. The patient developed a left pleural effusion M. intracellulare was repeatedly isolated from the pleural fluid. After antimycobacterial treatment, the patient`s pleural effusion resolved, but a left knee joint effusion developed newly and M. intracellulare was cultured from the joint fluid. At present, the patient has been taking antimycobacterial medication for 15 months but his left knee joint fluid remains positive for M. intracellulare. To our knowledge, this is the second reported case of disseminated NTM infection in a non-HIV infected patient in Korea.
증례 : 소화기 ; 혈액 담즙증으로 진단된 간내 담관 내 유두모양 담관암 1예
최원정 ( Won Jung Choi ),이상수 ( Shang Soo Lee ),노세희 ( Se Hui Noh ),천윤희 ( Yoon Hee Chun ),유지희 ( Ji Hee Yu ),이성구 ( Sung Koo Lee ),김명환 ( Myung Hwan Kim ) 대한내과학회 2009 대한내과학회지 Vol.77 No.3
담관 내 유두모양 종양은 드문 질환으로 흔히 재발성 폐쇄성 황달이나 우상복부 동통, 담관염 등의 증상으로 나타난다. 혈액담즙증으로 발현하는 경우는 극히 드문 것으로 알려져 있다. 저자들은 담관 유두종에서의 혈액담즙증을 경험하였기에 문헌고찰과 함께 보고하는 바이며 원인 미상의 혈액담즙증 환자에서 담관확장이 관찰되는 경우 담도경 검사를 시행하여 담관 유두종에 의한 출혈을 감별하여야 한다. Intraductal papillary neoplasm of the bile duct (biliary IPN) is a rare disease characterized by multicentric proliferation of adenomatous epithelium within the bile ducts. The common clinical manifestations are recurrent abdominal pain, jaundice, and acute cholangitis. We report a case of hemobilia caused by biliary IPN. A 59-year-old man was referred to our hospital because of hemobilia of unknown origin. Computed tomography and magnetic resonance cholangiography revealed dilatation of the S6 segmental duct with an ovoid-shaped intraductal mass. Percutaneous transhepatic cholangioscopy showed multiple papillary masses with bleeding in the S6 segmental duct. The patient underwent a right lobectomy, and the pathology revealed a well differentiated intraductal papillary adenocarcinoma. (Korean J Med 77:338-342, 2009)