Pediatric Infection and Vaccine

  • 제20권3호
  • /
  • Pages.190-196
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  • 2013
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  • 2384-1079(pISSN)
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  • 2384-1087(eISSN)
대한소아감염학회 (The Korean Society of Pediatric Infectious Diseases)
권호 표지

12세 여아에게서 활동성 폐결핵에 동반된 장결핵 1례

A Case of Tuberculous Enteritis with Active Pulmonary Tuberculosis in a 12-Year-Old Girl

  • 박가영 (순천향대학교 의과대학 소아과학교실) ;
  • 박재영 (순천향대학교 의과대학 소아과학교실) ;
  • 김창휘 (순천향대학교 의과대학 소아과학교실) ;
  • 곽정자 (순천향대학교 의과대학 병리학교실) ;
  • 박재옥 (순천향대학교 의과대학 소아과학교실)
  • Park, Ga Young (Department of Pediatrics, Soonchunhyang University College of Medicine) ;
  • Park, Jae Young (Department of Pediatrics, Soonchunhyang University College of Medicine) ;
  • Kim, Chang Hwi (Department of Pediatrics, Soonchunhyang University College of Medicine) ;
  • Kwak, Jeong Ja (Department of Pathology, Soonchunhyang University College of Medicine) ;
  • Park, Jae Ock (Department of Pediatrics, Soonchunhyang University College of Medicine)
  • 투고 : 2013.05.16
  • 심사 : 2013.09.04
  • 발행 : 2013.12.25
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초록

결핵은 다양한 임상양상을 보이는 감염병으로 과거에 비해 많이 감소하였고 소아 결핵도 점차 줄어들고 있으나 여전히 중요한 감염병이다. 소아의 결핵은 성인과는 다른 임상적 특징을 가지며 폐외 결핵의 빈도가 성인보다 높고, 청소년의 결핵은 결핵균 감염에서 실제 질병으로 발전될 위험이 크다. 폐외 결핵 중 장결핵은 증상이 비특이적이고 다양하여 진단이 늦어질 경우 사망률 및 이환율이 높아질 수 있다. 크론병 또는 만성적인 소화기 질환과의 감별이 중요하며, 최근 대장 내시경의 발달로 감별 진단이 용이해지고 있다. 저자들은 6개월간 지속된 설사와 복통, 체중 감소와 간헐적이고 반복적인 $37.5-38^{\circ}C$의 발열로 내원한 12세 여아에게서 대장 내시경 검사를 하여 시행한 생검 조직의 PCR 검사와 조직학적 소견으로 장결핵을 진단하였고, 연이어 촬영한 흉부 방사선 상 활동성 폐결핵으로 진단되어 11개월간의 항결핵제 치료로 완치된 증례를 경험하였다.

Intestinal tuberculosis (TB) is presented with nonspecific and variable clinical manifestations such as abdominal pain, diarrhea, fever and weight loss. Diagnosis of tuberculous enteritis may be missed or confused with many other chronic gastrointestinal disorders such as the Crohn disease and intestinal neoplasms. The diagnosis should be based on careful clinical evaluations, such as extra-intestinal signs and colonoscopic and histologic findings. Newer techniques such as PCR tests from the specimens through colonoscopic biopsy may be helpful to confirm diagnosis of tuberculous enteritis. The treatment regimens for pulmonary tuberculosis are generally effective for tuberculous enteritis as well. If not treated early, the prognosis of intestinal tuberculosis is poor. We report a case of tuberculous enteritis diagnosed by colonoscopic biopsy and TB PCR which was presented with diarrhea, abdominal pain, intermittent fever and weight loss in a 12-year-old girl with active pulmonary tuberculosis. The patient was treated successfully with antituberculosis agents for 11 months without any complications.

키워드

참고문헌

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