건강한 청소년에서의 치과 술기 후 Streptococcus anginosus 에 의한 acute acalculous cholecystitis

Acute Acalculous Cholecystitis with Bacteremia Caused by Streptococcus anginosus Following Dental Procedure in a Previously Healthy Adolescent

  • 김현오 (가톨릭대학교 의과대학 소아과학교실) ;
  • 염숙경 (가톨릭대학교 의과대학 소아과학교실) ;
  • 한승범 (가톨릭대학교 의과대학 소아과학교실) ;
  • 권효진 (고려대학교 의과대학 소아과학교실) ;
  • 강진한 (가톨릭대학교 의과대학 소아과학교실)
  • Kim, Hyun O (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Yum, Sook Kyung (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Han, Seung Beom (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Kwon, Hyo Jin (Department of Pediatrics, College of Medicine, Korea University) ;
  • Kang, Jin Han (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
  • 투고 : 2012.09.14
  • 심사 : 2012.10.22
  • 발행 : 2012.12.25

초록

Streptococcus anginosus는 Streptococcus milleri group에 속하는 viridians streptococci의 한 종으로, 사람의 구강, 상부 호흡기, 위장관 및 여성 생식기에 정상 세균총으로 존재하며, 숙주의 면역 상태에 따라 질환을 일으킬 수 있다. 저자들은 치과 치료 후 발열, 황달, 우상복부 불편감을 주소로 내원한 건강하였던 15세 남아에서 S. anginosus에 의한 균혈증이 동반된 급성 무결석 쓸개염을 진단하였고, 환아는 항균제 치료 후 호전되었다. 소아 청소년 시기에 흔하지 않은 급성 무결석 쓸개염이 기저 질환 없는 청소년에서 viridians streptococci에 의해 발생한 드문 경우이다.

Streptococcus anginosus is a member of Streptococcus milleri group, and is found in the oral mucosa, respiratory tract, and gastrointestinal tract as normal flora. It can develop into a disease in patients with deteriorating clinical condition or with clinical risk factors. A previously healthy 15-year-old boy was admitted due to fever, abdominal discomfort and vomiting which lasted for 7 days. He had a history of dental procedure 1 day before the development of fever. He was diagnosed with acute acalculous cholecystitis based on the clinical, laboratory, and imaging finding, and S. anginosus was isolated from the blood culture. The patient was successfully treated with antibiotic therapy.

키워드

참고문헌

  1. Ruoff KL. Streptococcus anginosus ("Streptococcus milleri"): the unrecognized pathogen. Clin Microbiol Rev 1988;1:102-8. https://doi.org/10.1128/CMR.1.1.102
  2. Claridge JE 3rd, Attorri S, Musher DM, Hebert J, Dunbar S. Streptococcus intermedius, Streptococcus constellatus, and Streptococcus anginosus ("Streptococcus milleri group") are of different clinical importance and are not equally associated with abscess. Clin Infect Dis 2001;32: 1511-5. https://doi.org/10.1086/320163
  3. Poole PM and Wilson G. Occurrence and cultural features of Streptococcus milleri in various body sites. J Clin Pathol 1979;32:764-8. https://doi.org/10.1136/jcp.32.8.764
  4. Salavert M, Gomez L, Rodriguez-Carballeira M, Xercavins M, Freixas N, Garau J. Seven-year review of bacteremia caused by Streptococcus milleri and other viridans streptococci. Eur J Clin Microbiol Infect Dis 1996;15: 365-71. https://doi.org/10.1007/BF01690091
  5. Admon D, Ephros MA, Gavish D, Raz R. Infection with Streptococcus milleri. J Infect 1987;14:55-60. https://doi.org/10.1016/S0163-4453(87)90834-6
  6. Tsakayannis DE, Kozakewich HP, Lillehei CW. Acalculous cholecystitis in children. J Pediatr Surg 1996;31:127-30. https://doi.org/10.1016/S0022-3468(96)90334-6
  7. Imamoglu M, Sarihan H, Sari A, Ahmetoglu A. Acute acalculous cholecystitis in children: diagnosis and treatment. J Pediatr Surg 2002;37:36-9. https://doi.org/10.1053/jpsu.2002.29423
  8. Ternberg JL, Keating JP. Acute acalculous cholecystitis. Complication of other illnesses in childhood. Arch Surg 1975;110:543-7. https://doi.org/10.1001/archsurg.1975.01360110089016
  9. Lo WT, Wang CC, Chu ML. Acute septicaemic acalculous cholecystitis complicated by empyema caused by Salmonella group D in a previously healthy child. Eur J Pediatr 2002;161:575-7. https://doi.org/10.1007/s00431-002-1051-4
  10. Sams RN, Haltiner AL, Botse-Baidoo E, Coomer C, Moosariparambil M, Catto BA. First report of Streptococcus bovis-associated acute cholecystitis in North America. J Clin Gastroenterol 2008;42:959-60. https://doi.org/10.1097/MCG.0b013e3180479452
  11. Batra V, Ang JY, Asmar BI. Staphylococcal acalculous cholecystitis in a child. South Med J 2003;96:206-8. https://doi.org/10.1097/01.SMJ.0000051277.81177.AA
  12. Gora-Gebka M, Liberek A, Bako W, Szarszewski A, Kami?ska B, Korzon M. Acute acalculous cholecystitis of viral etiology-a rare condition in children? J Pediatr Surg 2008;43:e25-7. https://doi.org/10.1016/j.jpedsurg.2007.09.013
  13. Mourani S, Dobbs SM, Genta RM, Tandon AK, Yoffe B. Hepatitis A virus-associated cholecystitis. Ann Intern Med 1994;120:398-400. https://doi.org/10.7326/0003-4819-120-5-199403010-00008
  14. Bert F, Bariou-Lancelin M, Lambert-Zechovsky N. Clinical significance of bacteremia involving the "Streptococcus milleri" group: 51 cases and review. Clin Infect Dis 1998;27:385-7. https://doi.org/10.1086/514658