Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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A Case of Mycobacterium Abscessus Pneumonia in a Patient with Systemic Lupus Erythematosus

전신성 홍반성 낭창 환자에서 발생한 Mycobacterium abscessus에 의한 폐렴 1예

  • Yim, Jae-Joon (Department of Internal Medicine and Lung Institute, Seoul National University, College of Medicine) ;
  • Oh, Myoung-Don (Department of Internal Medicine and Lung Institute, Seoul National University, College of Medicine) ;
  • Yoo, Chul-Gyu (Department of Internal Medicine and Lung Institute, Seoul National University, College of Medicine) ;
  • Song, Yeong-Wook (Department of Internal Medicine and Lung Institute, Seoul National University, College of Medicine) ;
  • Kim, Young-Whan (Department of Internal Medicine and Lung Institute, Seoul National University, College of Medicine) ;
  • Seo, Jung-Wook (Department of Pathology and Lung Institute, Seoul National University, College of Medicine) ;
  • Han, Sung-Gu (Department of Internal Medicine and Lung Institute, Seoul National University, College of Medicine) ;
  • Choe, Kang-Won (Department of Internal Medicine and Lung Institute, Seoul National University, College of Medicine) ;
  • Shim, Young-Soo (Department of Internal Medicine and Lung Institute, Seoul National University, College of Medicine)
  • 임재준 (서울대학교 의과대학 내과학교실 및 폐 연구소) ;
  • 오명돈 (서울대학교 의과대학 내과학교실 및 폐 연구소) ;
  • 유철규 (서울대학교 의과대학 내과학교실 및 폐 연구소) ;
  • 송영욱 (서울대학교 의과대학 내과학교실 및 폐 연구소) ;
  • 김영환 (서울대학교 의과대학 내과학교실 및 폐 연구소) ;
  • 서정욱 (서울대학교 의과대학 병리학교실 및 폐 연구소) ;
  • 한성구 (서울대학교 의과대학 내과학교실 및 폐 연구소) ;
  • 최강원 (서울대학교 의과대학 내과학교실 및 폐 연구소) ;
  • 심영수 (서울대학교 의과대학 내과학교실 및 폐 연구소)
  • Published : 1999.01.30
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Abstract

A 40-year-old female presented with fever and cough which had lasted for 3 months. Three years previously systemic lupus erythematosus had been diagnosed, and at that time 10mg of prednisone per day was prescribed. Crackles were heard at the base of the lung and her chest roentgenogram revealed diffuse infitrates in both lower lung fields. Despite of empirical antibiotics and antituberculous medication consisting of isoniczid, rifampicin and ethambutol, the patients condition deteriorated. We performed open lung biosy and numerous nodules with necrosis as well as acid fast bacilli were observed. After biochemical tests and sequencing, the organism was identified as Mycobacterium abscessus. The patient was treated with imipenem and amikacin ; patient's condition, as indicated by both symptoms and roentogenogram, subsequently improved.

전신성 홍반성 낭창으로 3년 전부터 스테로이드를 복용 중이던 40세의 여자 환자가 발열과 기침을 주소로 내원하였다. 환자의 증상과 방사선학적 소견은 경험적인 항균제 투여에 반응이 없었으며 개흉 폐생검의 결과 항산균을 관찰할 수 있었고 객담 항산균 배양 검사에서는 신속 성장균을 발견하여 생화학적 검사와 분자 생물학적 검사로 Mycobacterium abscessus로 확인하였다. 감수성 검사 결과에 따라 imipenem과 amikacin을 정주 투여하여 환자의 증상과 방사선 소견을 모두 호전시킬 수 있었다.

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