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다발성 골수종 환자에서 척추염을 동반한 브루셀라 심내막염
강용운 ( Yung Un Kang ),정영선 ( Young Sun Jung ),박경화 ( Kyung Hwa Park ),정숙인 ( Sook In Jung ),신종희 ( Jong Hee Shin ),안병희 ( Byung Hee Anh ),고관수 ( Kwan Soo Ko ) 대한내과학회 2008 대한내과학회지 Vol.74 No.5
저자들은 다발성골수종 환자에서 요천추 척추염과 경막 외 농양을 동반한 브루셀라 심내막염을 진단하고 적절한 항생제 치료와 대동맥 판막 치환술을 시행하여 호전을 보인 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Brucella endocarditis is a rare complication, but it is responsible for the majority of deaths related to this illness. A 67 year-old man presented with complaints of fever and lower back pain that he had experienced during the previous four weeks. The laboratory finding showed pancytopenia and an inverted total protein/globulin ratio. Multiple myeloma was diagnosed by bone marrow biopsy and serum electrophorosis. The spine MRI scan demonstrated spondylitis with epidural abscess (L5-S1). On the echocardiographic examination, there was vegetation on the right coronary cusp of the aortic valve and perivalvular abscess. The blood isolate was confirmed as Brucella abortus by using DNA sequencing of the 16S rRNA and the omp2a and omp2b genes. The clinical manifestations improved after appropriate antibiotics and aortic valve replacement. We describe here the first Korean case of human brucella endocarditis that was treated by valve replacement.(Korean J Med 74:561-565, 2008)