Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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A Case of Superior Vena Cava Syndrome Caused by Klebsiella Pneumonia

폐렴간균 폐렴에 의해 유발된 상대정맥 증후군 1예

  • Kim, Ju-Young (Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Lim, Chae-Man (Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Kim, Seon-Hee (Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Chu, Yun-Ho (Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Koh, Youn-Suck (Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Kim, Woo-Sung (Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Kim, Won-Dong (Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan)
  • 김주영 (울산대학교 의과대학 서울중앙병원 내과학교실) ;
  • 임채만 (울산대학교 의과대학 서울중앙병원 내과학교실) ;
  • 김선희 (울산대학교 의과대학 서울중앙병원 내과학교실) ;
  • 추윤호 (울산대학교 의과대학 서울중앙병원 내과학교실) ;
  • 고윤석 (울산대학교 의과대학 서울중앙병원 내과학교실) ;
  • 김우성 (울산대학교 의과대학 서울중앙병원 내과학교실) ;
  • 김원동 (울산대학교 의과대학 서울중앙병원 내과학교실)
  • Published : 1994.02.28
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Abstract

Superior vena cava(SVC) syndrome is mostly related to a malignant process, but many different benign causes have also been described. We report a case of SVC syndrome caused by Klebsiella pneumonia diagnosed by sputum culture and serial chest X-ray changes. A 27-year-old man had been in stable health until three days before admission, when he complained of pleuritic chest pain, facial flushing, and shortness of breath. Examination of the head and neck disclosed edema of face and both arms, and jugular venous distention to the angle of the jaw. The chest auscultation revealed decreased breath sound without crack1e on right upper lung field. The chest roentgenogram showed homogenous air space consolidation on right upper lobe, asociated with downward displacement of minor fissure and contralateral displacement of trachea, but air bronchogram was not seen. We began antibiotic therapy under impression of pneumonia after available culture was taken from blood and sputum. SVC scintigraphy showed stasis of drain of right brachiocephalic vein at the proximal portion with reflux into the right internal jugular vein and faintly visible SVC via the collaterals. Sputum culture revealed Klebsiella pneumoniae. Antibiotic therapy resulted in a cure of infection and disappearance of facial swelling. Follow-up SVC scintigraphy after 20 days showed normal finding. We first report a case of SVC syndrome caused by klebsiella pneunonia.

저자들은 폐렴간균 폐렴에 의한 우상엽의 용적 증가로 인하여 유발된 상대정맥 증후군 1예를 임상 경험한후 medline검색상 SVCS의 유발 원인으로서 폐렴간균 폐렴은 최초의 증례로 사료되므로 이에 보고하는 바이다.

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