Korean Journal of Clinical Laboratory Science (대한임상검사과학회지)

Korean Society for Clinical Laboratory Science (대한임상검사과학회)
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Study on Imported Case Dimorphic Fungi Isolated from Clinical Specimen in Korea

한국의 임상검체로부터 분리된 해외유입 두 형태 진균에 대한 연구

  • Lee, Jang Ho (Department of Clinical Laboratory Science, Semyung University) ;
  • Yu, Sungryul (Department of Clinical Laboratory Science, Semyung University) ;
  • Koo, Bon-Kyung (Department of Laboratory Medicine, Samsung Medical Center) ;
  • Moon, Cheol (Department of Clinical Laboratory Science, Semyung University)
  • 이장호 (세명대학교임상병리학과) ;
  • 유성률 (세명대학교임상병리학과) ;
  • 구본경 (삼성서울병원 진단검사의학과) ;
  • 문철 (세명대학교임상병리학과)
  • Received : 2018.01.31
  • Accepted : 2018.02.04
  • Published : 2018.03.31
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Abstract

Dimorphic fungi are characterized by the production of mycelia in the environment or when incubated at lower temperatures ($25{\sim}30^{\circ}C$) on media. The conversion to yeast occurs when invading a human body or when incubated at elevated temperatures ($35{\sim}37^{\circ}C$). Dimorphic fungi cause systemic infection and occur only in endemic regions; they can cause deep mycosis, which invades tissues and organs. Imported thermally dimorphic fungal pathogen has five genera, such as Coccidioides immitis, Histoplasma capsulatum, Blastomyces dermatitidis, Talaromyces (Penicillium) marneffei, and Paracoccidioides brasiliensis. Thus far, 30 cases of dimorphic fungi have been reported in Korea, including C. immitis in 18, H. capsulatum in 5, B. dermatitidis in 3, and T. marneffei in 4 cases. Three 3 cases of C. immitis, 2 cases of H. capsulatum, 1 case of B. dermatitidis, and 1 case of Talaromyces (Penicillium) marneffei were reported in Korea, even though no experience of an epidemic was present. None the dimorphic fungi except for Sporothrix schenkii (Dimorphic fungi) occur in Korea but are caused by endemic fungi that can be found only in specific regions and limited areas of foreign countries. Considering the trends of migratory locals and the increasing number of immigrants living in and returning home, the incidence of imported infections is expected to increase.

두 형태 진균은 자연환경이나 배지에 접종하여 실온에($25{\sim}30^{\circ}C$)에서 배양하면 균사체를 형성하는 특성을 가지고 있으며, 체온이나 높은 온도($35{\sim}37^{\circ}C$)에서 배양을 하면 효모형태를 나타나는 특성이 있다. 풍토병 지역에서만 발생하는 이들은 전신감염을 일으키며, 조직이나 기관에 침입하여 심부 진균 증을 일으키는 원인 진균이다. 사람에 감염되는 두 형태 진균은 지금까지 Blastomyces dermatitidis, Coccidioides immitis, Sporothrix schenkii, Talaromyces (Penicillium) marneffei, Histoplasma capsulatum, 그리고, Paracoccidioides brasiliensis 여섯 균종으로 알려져 있다. 지금까지 해외에서 유입되어 국내에 보고된 두 형태 진균은 Coccidioides immitis가 18예, Histoplasma capsulatum이 5예, Blastomyces dermatitidis가 3예, 그리고 Talaromyces (Penicillium) marneffei 가 4예로 모두 30예의 두 형태 진균이 보고되었다. 유행지역의 방문경험이 없음에도 국내에 발생된 경우는 C. immitis가 3예, H. capsulatum이 2예, B. dermatitidis가 1예, 그리고 Talaromyces (Penicillium) marneffei 가 1예로 있다. Sporothrix schenkii 를 제외한 모든 두 형태 진균이 국내에서는 발생하지 않고 외국의 특정 국가와 한정된 지역에서만 발생하는 풍토병 원인의 토착 진균이지만, 유행 지역의 여행 경험이나 호발 지역의 이민 거주자들의 귀국과 국내로 유입되는 외국인의 증가 추세를 고려하면 해외유입 감염증의 발생은 점점 증가할 것으로 사료된다.

Keywords

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