균혈증을 동반한 Klebsiella pneumoniae 이하선염 1예 = A Case of Kelbsiella pneumoniae Parotitis with Bacteremia

국문 초록 (Abstract)

급성 세균성 이하선염은 주로 노인 환자들에게서 흔히 나타나며, 여러 가지 위험인자가 있을 경우 발생 빈도가 증가한다. 원인균으로는 S. anureus 등의 그람 양성균이 가장 흔하지만 그 외 그람 음성균과 혐기성균에 의한 경우도 증가하고 있다. 급성 세균성 이하선염의 치료로는 기저질환에 대한 치료와 함께 적절한 항균제를 사용하는 것이다. 저자들은 급성 세균성 이하선염에 동반된 Klebsiella pneumoniae 균혈증 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

다국어 초록 (Multilingual Abstract)

Acute bacterial parotitis is primarily a disease of the aged and clinically ill patients. Dehydration, dry mouth resulting from surgery or medication use, sialotithiasis, malnutrition and systemic illness are prominent predisposing factors. Staphylococcus aureus is the most common pathogen associated with acute bacterial parotitis. However, streptococci, gram-negative bacteria, and anaerobes have also been reported to be associated with the disease. Nevertheless, acute parotitis caused by Klebsiella pneumoniae has never been earlier reported in Korea. We describe a case of acute parotitis which developed in a 73 year-old women with K. pneumoniae bacteremia. In this case, the patient initially received supportive care. Oral amoxicillin/clavulanic acid were initiated because the painful swelling of the left parotid gland, and overlying erythema was aggravated and pus from Stensen's duct was drained. She complained of fever in spite of oral amoxicillin/claulanic acid administration for 4days. Then, the antibiotics were switched to intravenous ampicillin/sulbactam, and the patient recovered fully after 2 weeks of intravenous antibiotics therapy.