Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
권호 표지

A Case of Blastomycosis after Traveling around Non-Endemic Area

비 유행지역 여행 후 발생한 분아균증 1례

  • Seo, Chang Gyun (Department of Internal Medicine, Kyungju-Dongsan Hospital) ;
  • Seo, Young Woo (Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Park, Hun Pyo (Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Choi, Won Il (Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Beom, Han Seung (Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Kwon, Kun Young (Department of Pathology, Keimyung University School of Medicine) ;
  • Suh, Soo Ji (Department of Diagnostic Radiology, Keimyung University School of Medicine) ;
  • Jeon, Young June (Department of Internal Medicine, Keimyung University School of Medicine)
  • 서창균 (경주 동산병원 내과) ;
  • 서용우 (계명대학교 의과대학 내과학교실) ;
  • 박훈표 (계명대학교 의과대학 내과학교실) ;
  • 최원일 (계명대학교 의과대학 내과학교실) ;
  • 한승범 (계명대학교 의과대학 내과학교실) ;
  • 권건영 (계명대학교 의과대학 병리학교실) ;
  • 서수지 (계명대학교 의과대학 진단방사선학교실) ;
  • 전영준 (계명대학교 의과대학 내과학교실)
  • Received : 2005.05.02
  • Accepted : 2005.06.07
  • Published : 2005.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Blastomycosis is a systemic pyogranulomatous disease that is caused by a thermally dimorphic fungus, Blastomyces dermatitidis. it's the disease is endemic in the south-eastern and south central states of the USA, which border the Mississippi and Ohio Rivers, the mid-western states and Canadian provinces bordering the Great Lakes as well as in a small area of New York and Canada adjacent to the St. Lawrence River. We encountered a case of blastomycosis, representing as a pulmonary manifestation after traveling around a nonendemic area and report it with a brief review of the relevant literature.

분아균증은 Blastomyces dermatitidis라는 진균에 의해 유발되며, 발생지역으로는 아프리카와 일부 다른 지역에서 발생 보고가 있으나, 호발지역은 북미의 남동부, 남중부, 중서부 지역이며, 국내에서는 아직 발생 보고가 없는 실정이다. 감염은 주로 오염된 토양으로부터 분생자의 흡인으로 인해 주로 폐 감염으로 시작되며, 폐 이외에 주로 침범되는 장기는 피부, 뼈, 중추신경계 등이 있다. 폐 감염의 경우 방사선학적으로 매우 다양한 형태를 보여 진단이 용이하지 않으며, 세균성 폐렴, 결핵, 히스토플라즈마증, 급성호흡곤란증후군, 폐암 등으로 오인되기도 한다. 치료는 경증의 폐감염만 있는 경우에 자연 치유되는 경우가 있으나, 나머지는 장기간의 항진균제 사용이 권장된다. 저자들은 비 유행지역을 여행 후 발생한 분아균증 1례 경험하였기에 보고하는 바이다.

Keywords

References

  1. Klein BS, Vergeront JM, Davis JP. Epidemiologic aspects of blastomycosis: the enigmatic systemic mycosis. Semin Respir Infect 1986;1:29-39
  2. Reingold AL, Lu XD, Plikaytis BD, Ajello L. Systemic mycoses in the United States, 1980-1982. J Med Vet Mycol 1986;24:433-6
  3. Proter ME, Davis JP. Blastomycosis: Wisconsin, 1986-1995. MMWR Morb Mortal Wkly Rep 1996;45:601-3
  4. Fujio J, Nishimura K, Miyaji M. Epidemiological survey of the imported mycoses in Japan. Nippon Ishinkin Gakkai Zasshi 1999;40:103-9 https://doi.org/10.3314/jjmm.40.103
  5. Sarosi GA, Davies SF. Blastomycosis. Am Rev Respir Dis 1979;120:911-38
  6. Klein BS, Vergeront JM, Weeks RJ, Kumar UN, Mathai G, Varkey B, et al. Isolation of blastomcyces dermatitidis in soil associated with a large outbreak of blastomycosis in Wisconsin. N Engl J Med 1986;314:529-34 https://doi.org/10.1056/NEJM198602273140901
  7. Sarosi GA, Hammerman KJ, Tosh FE, Kronenberg RS. Clinical features of acute pulmonary blastomycosis. N Engl J Med 1974;290:540-3 https://doi.org/10.1056/NEJM197403072901004
  8. Goldman M, Johnson PC, Sarosi GA. Fungal pneumonias: the endemic mycoses. Clin Chest Med 1999;20:507-19 https://doi.org/10.1016/S0272-5231(05)70232-X
  9. Sarosi GA, Davies SF, Philips JR. Self-limited blastomycosis: a report of 39 cases. Semin Respir Infect 1986;1:40-4
  10. Meyer KC, McManus EJ, Maki DG. Overwhelming pulmonary blastomycosis associated with the adult respiratory distress syndrome. N Engl J Med 1993;329:1231-6 https://doi.org/10.1056/NEJM199310213291704
  11. Chapman SW. Blastomyces dermatitidis. In: Mandell GL, Bennell JE, Dolin R, editors. Principles and practice of infectious diseases. 5th ed. Philadelphia: Churchill Livingston; 2000. p. 2353-65
  12. Martyowicz MA, Prakash UB. Pulmonary blastomycosis: an appraisal of diagnostic techniques. Chest 2002;121:768-73 https://doi.org/10.1378/chest.121.3.768
  13. Taylor MR, Lawson LA, Boyce JM, Lockwood WR. Inhibition of Blastomyces dermatitidis by topical lidocaine. Chest 1983;84:431-5 https://doi.org/10.1378/chest.84.4.431
  14. Chapman SW, Bradsher RWJr, Cambell GD Jr, Pappas PG, Kauffman CA. Practice guidelines for the management of patients with blastomycosis. Clin Infect Dis 2000;30:679-83 https://doi.org/10.1086/313750
  15. Schutze GE, Hickerson SL, Fortin EM, Shellhase DE, Daville T, Gubbins PO, et al. Blastomycosis in children. Clin Infect Dis 1996;22:496-502 https://doi.org/10.1093/clinids/22.3.496