• Title/Summary/Keyword: Immunocompetent patient

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A Case of Endobronchial Aspergilloma Presented by Solitary Pulmonary Nodule (고립성 폐 결절 형태로 나타난 기관지 내 국균종 1예)

  • Lee Ki-Man;Kim Sung-Jin;Hong Jong-Myeon
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.648-651
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    • 2006
  • A 53 year-old woman visited to our hospital due to increased hemoptysis for 4 days. The chest X-ray showed solitary pulmonary nodule on right upper lobe and computed tomography of chest demonstrated mass on posterior segmental bronchus of right upper lobe. Bronchoscopic examination revealed that this segmental bronchus was completely obstructed by a yellow and brownish mud like mass, which was identified as an aspergilloma by pathologic examination. Patient had undergone bilobectomy because of persistent hemoptysis. Tracheobronchial apergillosis in an immunocompetent person is very rare disease. then, we report this case with review of the Korean literature.

Pulmonary Cryptococcosis That Was Suspected to be Metastatic Lung Cancer (전이성 폐암으로 추정된 폐효모균증)

  • Kim, Jong In;Cho, Sung Rae;Kye, Yeo Kon
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.123-126
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    • 2009
  • Cryptococcosis is a subacute or chronic inflammation that's caused by infection from cryptococcus neoformans in the soil or dust that's contaminated by pigeon droppings. Pulmonary cryptococcosis occurs in immunocompromised patients, and particularly in HIV positive patients, but it rarely occurs in immunocompetent individuals. It is most often detected as asymptomatic single or multiple nodules that are found by chest X-ray examination. In these situations, the diagnosis for most cases is made by the histology of the resected lesion. We report here on a case of solitary nodular pulmonary cryptococcosis that occurred in a 32 years old female patient who underwent thyroidectomy for treating her thyroid cancer.

A Case of Pyogenic Liver Abscess Caused by Staphylococcus epidermidis in a Healthy Child (건강한 소아에서 발생한 Staphylococcus epidermidis에 의한 화농성 간농양 1례)

  • Gwak, Ji Hye;Eem, Yeun Joo;Choi, Ui Yoon;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.20 no.1
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    • pp.36-40
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    • 2013
  • Staphylococcus epidermidis is a normal inhabitant of skin, throat, mouth, vagina, and urethra. It is not usually pathogenic, particularly in immunocompetent hosts. This report describes a case of a pyogenic liver abscess caused by Staphylococcus epidermidis in a healthy 12-year-old boy. He was admitted to Seoul St. Mary's Hospital with intermittent fever for 6 days. Findings on abdominal computed tomography (CT) showed a mass measuring $7.0{\times}6.5$ cm in the right hepatic lobe. Culture of the abscess resulted in growth of Staphylococcus epidermidis as a causative organism. The patient was successfully treated with intravenous administration of antibiotics and percutaneous drainage of the abscess.

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Solitary Jejunal Tuberculosis with Intestinal Obstruction in an Immunocompetent Patient (면역 능력이 있는 성인에서의 장폐색을 동반한 단일 공장 결핵 1예)

  • Bae, Hyun Jin;Park, Jong Ho;Jin, Su Sin;Jung, Jiyun;Nam, Yun Jung;Kim, Da Won
    • The Korean Journal of Medicine
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    • v.93 no.6
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    • pp.556-559
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    • 2018
  • Intestinal tuberculosis is an infection of the gastrointestinal tract by the Mycobacterium tuberculosis complex. To the best of our knowledge, solitary intestinal tuberculosis accompanied by intestinal obstruction, particularly in the middle of the small intestine, is extremely rare. We report a case of solitary jejunal tuberculosis in a 49-year-old man with no underlying disease. He was admitted a few days after the onset of diffuse abdominal discomfort. Upon evaluation, we initially considered a malignancy of the distal jejunum with ileus due to the presence of a mass. Therefore, he underwent laparoscopic resection of the small bowel. Unexpectedly, the histologic specimen showed a chronic caseating granulomatous lesion with acid-fast bacilli. Ultimately, he was diagnosed with solitary jejunal tuberculosis. He was successfully treated with anti-tuberculosis drugs without any complications.

Multidrug-Resistant Tuberculosis Presenting as Miliary Tuberculosis without Immune Suppression: A Case Diagnosed Rapidly with the Genotypic Line Probe Assay Method

  • Ko, Yousang;Lee, Ho Young;Lee, Young Seok;Song, Junwhi;Kim, Mi-Yeong;Lee, Hyun-Kyung;Shin, Jeong Hwan;Choi, Seok Jin;Lee, Young-Min
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.5
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    • pp.245-248
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    • 2014
  • Miliary tuberculosis (TB) is a rare extrapulmonary form of TB, and there have been only two reports of miliary TB associated with infection with multidrug-resistant (MDR)-TB pathogen in an immunocompetent host. A 32-year-old woman was referred to our hospital because of abnormal findings on chest X-ray. The patient was diagnosed with MDR-TB by a line probe assay and was administered proper antituberculous drugs. After eight weeks, a solid-media drug sensitivity test revealed that the pathogen was resistant to ethambutol and streptomycin in addition to isoniazid and rifampicin. The patient was then treated with effective antituberculous drugs without delay after diagnosis of MDR-TB. To the best of our knowledge, this is the first case of miliary TB caused by MDR-TB pathogen in Korea.

Pulmonary Cryptococcosis Mimicking Primary Lung Cancer with Multiple Lung Metastases

  • Kim, Yu Seung;Lee, In Hee;Kim, Hyun Seon;Jin, Su Sin;Lee, Jong Hwan;Kim, Sung-Kyoung;Song, So Hyang;Yoo, Jinyoung;Kim, Chi Hong;Kwon, Soon Seog
    • Tuberculosis and Respiratory Diseases
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    • v.73 no.3
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    • pp.182-186
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    • 2012
  • Cryptococcosis is an invasive fungal infection, which is more common in immunocompromised patients. However, pulmonary cryptococcosis can occur in immunocompetent patients and should be considered on a differential diagnosis for nodular or mass-like lesions in chest radiograph. Recently, we experienced a patient with pulmonary cryptococcosis, successfully treated with oral fluconazole therapy. A 74-year-old female patient was referred for an evaluation of abnormal images, a large consolidative mass with multiple nodular consolidations and small nodules that mimics primary lung cancer with multiple lung to lung metastases. Computed tomography-guided lung biopsy confirmed the diagnosis of pulmonary cryptococcosis. The follow-up image taken after 4 months with oral fluconazole treatment showed marked improvement.

Dyspnea Due to Candidal Septic Pulmonary Embolism Originated from Odontogenic Infection (치성감염에서 유래한 칸디다성 폐색전증으로 인한 호흡곤란)

  • Jeong, Ki-Hyun;Cho, Hyun-Jae;Jang, Kun-Soo;Jeon, Jae-Yun;Shim, Kwang-Sup;Hwang, Kyung-Gyun;Park, Chang-Joo
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.2
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    • pp.115-117
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    • 2014
  • Septic pulmonary embolism is a rare disease entity that consists of pulmonary infection and embolism predominantly arising from endocarditis and thrombophlebitis. We report a rare case of candidal septic pulmonary embolism secondary to odontogenic infection in a previously healthy and immunocompetent man, who had a submandibular abscess with dyspnea and fever. The patient was not responsive to prolonged broad spectrum antibiotics and surgical drainage, however, antifungal therapy was successful after Candida albicans was confirmed by his blood culture. Since proper identification and the resolution of the septic origin is as important as the diagnosis of septic pulmonary embolism, in a patient with odontogenic infection, who shows definite respiratory complications despite antimicrobial therapy with surgical drainage, various culture examinations should be adopted.

A Case Report of Three Patients with Nontuberculous Mycobacterial Pulmonary Disease Caused by Mycobacterium kansasii (Mycobacterium kansasii에 의한 비결핵성 마이코박테리아 폐질환 3례)

  • Koh, Won Jung;Kwon, O Jung;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Lee, Nam Yong;Kim, Tae Sung;Lee, Kyung Soo;Park, Eun Mi;Park, Young Kil;Bai, Gill Han
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.4
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    • pp.459-466
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    • 2003
  • Mycobacterium kansasii is the second most common cause of nontuberculous mycobacterial pulmonary disease in Western countries and Japan. The clinical and radiological features of pulmonary disease caused by M. kansasii usually resemble those of pulmonary tuberculosis including cavitary infiltrates with an upper lobe predilection. It is also now apparent that patients with M. kansasii pulmonary disease can present with noncavitary nodular bronchiectatic infiltrates similar to lung diseases of M. avium complex. With rifampin-containing regimens, treatment success rates are almost 100%. Timely diagnosis before the development of extensive disease and effective overall treatment strategies are very important to ensure that patients receive the appropriate medications for a sufficiently long period of time. To our knowledge, there has been no Korean case report of M. kansasii pulmonary disease in the immunocompetent patient until now. We report three cases of M. kansasii pulmonary disease in immunocompetent adult patients.

Aspergillosis of Central Nervous System (중추신경계의 Aspergillosis)

  • You, Seung-Hoon;Lee, Jung-Il;Nam, Do-Hyun;Kim, Jong-Soo;Hong, Seung-Chyul;Shin, Hyung-Jin;Park, Kwan;Eoh, Whan;Kim, Jong-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.7
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    • pp.896-902
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    • 2001
  • Objectives : Aspergillosis of central nervous system(CNS) is a rare pathologic condition and it has been known to be difficult to diagnose and treat. We analyzed seven cases of central nervous system aspergillosis. The clinical characteristics, and the problems in diagnosis and treatment are discussed with review of previous literatures. Material and Methods : We reviewed the clinical records, radiological findings, and pathologic reports of 7 patients with aspergillosis which involved CNS. Results : Five patients were immunocompetent, and infection was related with previous operation in 4 of them. Two patients were immunocompromised and had no history of operation. Five patients had intracranial lesions and two had spinal lesions. Mean duration from the onset of initial symptom to pathologic diagnosis was 2.4 months. Mean duration from the previous operation to the onset of symptom was 9.3 months, and from the onset of symptom to diagnosis was 2.9 months in the patients who had histories of operation. All of them were treated with surgical procedures and intravenous and oral antifungal agents, resulting in cure in 6 cases. Mean duration of the treatment was 4.9 months. Conclusion : Because aspergillosis of CNS is a rare disease and is difficult to be differentiated from the pyogenic abscess or recurrent tumor, the pathologic diagnosis is very important for adequate treatment. Although the prognosis of aspergillosis of CNS has been known to be poor, adequate surgery for both diagnosis and treatment and antifungal chemotherapy resulted in good outcome.

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A review of Gymnophalloides seoi (Digenea: Gymnophallidae) and human infections in the Republic of Korea

  • Lee, Soon-Hyung;Chai, Jong-Yil
    • Parasites, Hosts and Diseases
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    • v.39 no.2
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    • pp.85-118
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    • 2001
  • Studies on Gymnophalloides seoi (Digenea: Gymnophallidae) and human infections are briefly reviewed. This minute intestinal fluke was first discovered from a Korean woman suffering from acute pancreatitis and gastrointestinal troubles. It was described as a new species by Lee, Chai and Hong in 1993. The southwestern coastal village where the patient resided was found to be a highly endemic area, and additional endemic areas have been identified. The parasite is very small, 0.33-0.50 mm long and 0.23-0.33 mm wide. and characterized by the presence of a ventral pit. The first intermediate host remains unknown, but the second intermediate host has been found to be the oyster Crassostrea gigas. Man and the Palearctic oystercatcher Haematopus ostralegus have been shown to be natural definitive hosts , and wading birds including the Dentish plover Charadrius alexandrinus are highly susceptible to experimental infection. Gerbils, hamsters, cats, and several strains of mice were also susceptible laboratory hosts. In experimentally infected mice, the parasites inhabit the small intestine, pinching and sucking the root of villi with their large oral suckers, but they did not invade beyond the mucosa in immunocompetent mice. However, they were found to invade the submucosa in immunosuppressed mice. Human G. seoi infections have been found in at least 25 localities; 23 islands on the Yellow Sea or the South Sea, and 2 western coastal villages. The highest Prevalence was found in a village on Aphaedo. Shinan-fun (49% e99 Positive rate) : other areas showed 0.8-25.3% prevalence. Infected people complained of variable degrees of gastrointestinal troubles and indigestion. The infection can be diagnosed by recovery of eggs in the feces; however, an expert is needed to identify the eggs. Praziquantel, 10mg/kg in single dose, is effective for treatment of human infections. Eating raw oysters in endemic areas should be avoided.

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