Pediatric Infection and Vaccine

  • 제25권1호
  • /
  • Pages.54-59
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  • 2018
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  • 2384-1079(pISSN)
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  • 2384-1087(eISSN)
대한소아감염학회 (The Korean Society of Pediatric Infectious Diseases)
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만성 복통과 발진을 주소로 내원한 6세 여아에서 진단된 폐흡충증 1예

A Case of Pulmonary Paragonimiasis with Chronic Abdominal Pain and Erythematous Rash in a 6-year-old Girl

  • 김주영 (한림대학교 의과대학 강남성심병원 소아청소년과) ;
  • 박민규 (한일병원 소아청소년과) ;
  • 이용주 (한림대학교 의과대학 강남성심병원 소아청소년과) ;
  • 허선 (한림대학교 의과대학 기생충학교실) ;
  • 조기영 (한림대학교 의과대학 강남성심병원 소아청소년과)
  • Kim, Ju Young (Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Park, Min Kyu (Department of Pediatrics, KEPCO Medical Center) ;
  • Lee, Yong Ju (Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Huh, Sun (Department of Parasitology, Hallym University College of Medicine) ;
  • Cho, Ky Young (Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine)
  • 투고 : 2017.07.29
  • 심사 : 2017.10.24
  • 발행 : 2018.04.25
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초록

기생충 감염은 소아 인구에게서 드물기 때문에 진단이 어려울 수 있다. 환아는 6개월 동안 간헐적인 상복부 통증과 양손과 양측 팔 모두에 발생한 홍반성 발진을 동반한 늑막 삼출을 주소로 내원하였다. 환아는 검사상 혈청 호산구증가와 현저한 삼출성, 호산구성 흉막삼출액이 확인되었다. 동시에 폐렴 미코플라스마에 대한 높은 항체가 때문에 항생제 치료를 받았으나 흉막삼출은 호전되지 않았다. 환아의 분변에서 시행한 기생충 알의 검사상 음성이었으나 혈청 및 흉막삼출액의 기생충 특이 항원에 대한 면역효소측정법에서 폐흡충 특이 IgG에 대해 양성을 보였다. Praziquantel의 치료 후 호흡기 증상, 흉수 및 피부 증상이 호전되었다. 이에 만성 복통과 홍반성 발진을 주소로 내원한 소아 환자에서 폐흡충에 의한 흉막삼출액을 진단 및 치료하였기에 보고하는 바이다.

Pleural paragonimiasis is uncommon in the pediatric population and therefore can be challenging to diagnose. This is a case of a 6-year-old girl with pleural effusion who had been having intermittent persistent epigastric pain and erythematous rash on the face, hands, and arms for 6 months. Exudative pleural effusion with prominent eosinophils and serum eosinophilia were observed. As patient showed high immunoglobulin M (IgM) titers against Mycoplasma pneumoniae, she was treated with antibiotics; however, the pleural effusion did not improve during hospitalization. Despite showing negative stool ova and cyst results, patient's serum and pleural effusion were positive for Paragonimus westermani-specific IgGs on enzyme-linked immunosorbent assay. Respiratory symptoms, pleural effusion, and skin symptoms improved after praziquantel treatment.

키워드

참고문헌

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피인용 문헌

  1. Status of common parasitic diseases in Korea in 2019 vol.62, pp.8, 2018, https://doi.org/10.5124/jkma.2019.62.8.437