기관지 방선균증과 동반된 이차성 기질화 폐렴 1예

A Case of Secondary Organizing Pneumonia Associated with Endobronchial Actinomycosis

  • 이병훈 (을지의과대학교, 을지병원 내과) ;
  • 이기덕 (을지의과대학교, 을지병원 내과) ;
  • 김상훈 (을지의과대학교, 을지병원 내과) ;
  • 우정주 (을지의과대학교, 을지병원 영상의학과)
  • Lee, Byoung Hoon (Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine) ;
  • Lee, Ki-Deok (Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine) ;
  • Kim, Sang Hoon (Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine) ;
  • Woo, Jeong Joo (Department of Radiology, Eulji General Hospital, Eulji University School of Medicine)
  • 투고 : 2007.01.15
  • 심사 : 2007.02.21
  • 발행 : 2007.03.30

초록

여러 원인균에 의하여 이차성 기질화 폐렴이 발생할 수 있는데, 감염에 대한 활동성의 염증반응이 진행하여 폐포내의 섬유질의 삼출물이 기질화 됨으로서 발생한다. 아급성으로 발생한 기침, 객담, 발열 등을 주소로 내원한 평소 건강하게 지내던 37세 남자에서, 기관지 내시경과 경피 폐세침 흡인생검을 통하여 기관지 방선균증에 동반된 이차성 기질화 폐렴을 진단하고 치료하였다. 방선균증이 이차성 기질화 폐렴의 원인이 될 수 있음을 본 증례는 보여주고 있다.

Several types of infection can cause organizing pneumonia when the inflammatory process remains active with the further organization of the intra-alveolar fibrinous exudates, despite the control of the infectious organism by antibiotics. We report a case of 37-year-old male with secondary organizing pneumonia associated with an endobronchial actinomycosis. The patient presented with a subacute cough, sputum and fever. Bronchial biopsy revealed sulfur granule to be consistent with the actinomycosis, and percutaneous needle biopsy revealed typical pattern of organizing pneumonia. The patient was treated with the appropriate antibiotics and corticosteroid. There was rapid improvement in the symptoms and radiological findings, and after six months of treatment, the corticosteroid dose was tapered off without a recurrence of the organizing pneumonia.

키워드

참고문헌

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