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증례 : Mycobacterium Abscessus에 의한 척추골수염 1예
김병훈 ( Byung Hoon Kim ),박진선 ( Jin Sun Park ),장영락 ( Young Rock Jang ),김진용 ( Jin Yong Kim ),조용균 ( Yong Kyun Cho ) 대한내과학회 2012 대한내과학회지 Vol.83 No.2
비결핵항산균은 결핵균과 나병균을 제외한 항산균을 말하며 최근 우리나라에서 감염률이 점차 증가하고 있어 그 중요성이 크게 대두되고 있는 상황이다. 이들 중 M. abscessus는 대표적인 신속발육군으로 피부, 연조직, 골감염을 흔히 유발한다. 본 증례에서는 상습적으로 침술과 같은 침습적 시술을 시행 받고 나서 발생한 M. abscessus척추 골수염 환자에게 항생제 병합치료와 광범위 수술적 처치를 시행하여 완치를 경험하였다. The designation nontuberculous mycobacteria (NTM) applies to mycobacterial species other than organisms of the Mycobacterium tuberculosis complex and Mycobacterium leprae, In recent decades, the prevalence of human disease caused by NTM has increased; thus, the clinical significance of NTM is increasing. Mycobacterium abscessus is a rapidly growing nontuberculous mycobacterial species that is usually associated with chronic pulmonary disease, posttraumatic soft-tissue infections, nosocomial bloodstream infections, wound infections, and abscesses at the site of prior intramuscular injections; however, vertebral osteomyelitis due to this species is rare. Here, we present a case of vertebral osteomyelitis due to M. abscessus that occurred in a patient with iatrogenic Cushing`s syndrome and a history of acupuncture who was treated with wide surgical excision and prolonged combined antibiotic treatment.
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Candida albicans에 의한 피부하 농양 2예
박진선;김병훈;장영락;최우석 김진용;조용균 중앙대학교 의과대학 의과학연구소 2012 中央醫大誌 Vol.37 No.1/2
Candidal subcutaneous abscess is very rare. However, without noticing it, we can confront poor outcomes such as treatment failure, prolonged therapeutic duration, various complicated organ diseases. Furthermore, it tends to gradually increase so we have to consider about it. We present two patients with subcutaneous abscess due to Candida albicans not secondary to hematogenous or disseminated infection which is first case in Korea and we have cured successfully with surgical drainage and antifungal agent. There is no confirmative therapeutic guideline about candidal subcutaneous abscess yet, because of its rarity, but in the future, we need to concern about candidal subcutaneous abscess and establish appropriate treatment.
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