Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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A Case of Intestinal Tuberculosis Complicated with Pulmonary Tuberculosis in a Young Aldolescent with Cerebral Palsy

뇌성마비 소아에서 진단된 폐결핵에 병발된 결핵성 장염 1례

  • Choi, Sung Yun (Department of Pediatrics, School of Medicine, Eulji University) ;
  • Kim, Young Min (Department of Pediatrics, School of Medicine, Eulji University) ;
  • Bae, Sun Hwan (Department of Pediatrics, School of Medicine, Eulji University)
  • 최성윤 (을지의과대학 노원을지병원 소아과학교실) ;
  • 김영민 (을지의과대학 노원을지병원 소아과학교실) ;
  • 배선환 (을지의과대학 노원을지병원 소아과학교실)
  • Received : 2004.03.03
  • Accepted : 2004.03.20
  • Published : 2004.03.01
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Abstract

About 20% of intestinal tuberculosis have active pulmonary tuberculosis. Intestinal tuberculosis can develop by swallowing sputum which have active pulmonary tuberculosis and by ingestion of contagious milk. We report a case of intestinal tuberculosis complicated with pulmonary tuberculosis in a 15-year old aldelescent who could not cough out sputum because of known cerebral palsy. He was admitted because of 3 day history of fever and bloody stool. Chest PA showed both upper lobe consolidation. AFB stain and AFB PCR was positive for tuberculosis. Colon study showed abscence of haustral marking and lead pipe appearance due to stenosis of ascending colon and mucosal edema. Abdominal CT scan showed mild wall thickening in ascending colon. Despite the anti-tuberculosis therapy with first line drugs, fever accompanying pleural effusion developed. Second line drug with Isoniazid and Rifampin improved clinical manifestation. After the report on sensitivity, we readjusted the regimen, and clinical manifestations improved gradually.

저자들은 객담을 뱉지 못하는 뇌성마비 환아에서 객담 검사와 방사선학적 검사, 대장 조영술과 복부전산화단층촬영 검사를 통해, 폐결핵에 동반되어 상행 결장을 침범한 장결핵을 진단하고 항결핵제를 투여하여 임상적 호전을 가져온 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

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