• Tuberculosis and Respiratory Diseases
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• 제79권2호
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• pp.101-103
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• 2016

Nocardia species are aerobic, gram-positive pathogens found worldwide in soil. Nocardia is considered an opportunistic pathogen, and its infection mostly occurs in immunocompromised patients. We report a case of Nocardia farcinica induced mediastinitis and pneumonia that occurred in a 64-year-old male patient who had no significant medical history except for hypertension. He visited another hospital with a complaint of dyspnea and left chest wall pain. The symptoms arose 7 days ago without any trauma and they worsened. A mediastinal mass was found on computed tomography scan. After being transferred to our hospital for further evaluation, he was diagnosed with mediastinitis and pneumonia. As N. farcinica was found to be the causative organism by 16S rRNA sequencing, proper antibiotic therapy including trimethoprim/sulfamethoxazole was initiated immediately. After this, the patient improved and he was discharged. If an infection has a disseminating course, nocardiosis cannot be excluded even in immunocompetent patients. Once the diagnosis is established, prompt antibiotic therapy should be performed based on the severity.

• Journal of Trauma and Injury
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• 제33권2호
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• pp.119-123
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• 2020

The Coronavirus disease 2019 (COVID-19) has rapidly spread across the world and caused a pandemic. It can be transmitted by an infected person or an asymptomatic carrier and is a highly contagious disease. Prevention and early identification of COVID-19 are important to minimize the transmission of COVID-19. Chest computed tomography (CT) has a high sensitivity for detecting COVID-19, but relatively low specificity. Therefore, chest CT may be difficult to distinguish COVID-19 findings from those of other infectious (notably viral types of pneumonia) or noninfectious disease. Pulmonary contusion has also a lot of similarities on chest CT with COVID-19 pneumonia. We present trauma patients with pulmonary contusion whose CT scans showed findings similar to those of COVID-19, and we report our experience in the management of trauma patients during the COVID-19 pandemic.

• Tuberculosis and Respiratory Diseases
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• 제64권4호
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• pp.309-313
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• 2008

미만성 폐포출혈은 흔히 교원성질환에 동반되어 발생하나 거대세포바이러스 폐렴과 동반되어 나타날 수 있으며 병인은 아직 밝혀지지 않았다. 따라서 이 두 질환의 연관관계에 대한 연구가 필요하다. 저자들은 뇌출혈로 입원 후 장기간 치료 중이던 환자에서 거대세포바이러스 폐렴과 이에 동반된 미만성 폐포출혈 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Pediatric Infection and Vaccine
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• 제4권2호
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• pp.271-275
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• 1997

We experienced a case of Henoch-Sch$\ddot{o}$nlein purpura associated with Mycoplasma pneumoniae pneumonia in a 28 month old male who suffered from cough, abdominal pain and both leg swelling and pain. Physical examination showed varying sized purpura, characteristic of Henoch-Sch$\ddot{o}$nlein purpura, below both knee. Laboratory test revealed Mycoplasma pneumoniae antibody titer >1:2,560 and cold agglutinins titer 1:64. Chest X-ray showed peribronchial blurring in both lung fields. The patient was treated with midecamycin and prednisolone for 7 days and responded to the treatment well. The authors report a case of Henoch-Sch$\ddot{o}$nlein purpura with Mycoplasma pneumoniae pneumonia with brief review of related literatures.

• Korean Journal of Radiology
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• 제1권2호
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• pp.73-78
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• 2000

Objective: To describe the HRCT findings of cytomegalovirus (CMV) pneumonia in non-AIDS immunocompromised patients Materials and Methods: This retrospective study involved the ten all non-AIDS immunocompromised patients with biopsy-proven CMV pneumonia and without other pulmonary infection encountered at our Medical Center between January 1997 and May 1999. HRCT scans were retrospectively analysed by two chest radiologists and decisions regarding the findings were reached by consensus. Results: The most frequent CT pattern was ground-glass opacity, seen in all patients, with bilateral patchy (n = 8) and diffuse (n = 2) distribution. Other findings included poorly-defined small nodules (n = 9) and consolidation (n = 7). There was no zonal predominance. The small nodules, bilateral in eight cases and unilateral in one, were all located in the centrilobular region. Consolidation (n = 7), with patchy distribution, was bilateral in five of seven patients (71%). Pleural effusion and bilateral areas of thickened interlobular septa were seen in six patients (60%). Conclusion: CMV pneumonia in non-AIDS immunocompromised patients appears on HRCT scans as bilateral mixed areas of ground-glass opacity, poorly-defined centrilobular small nodules, and consolidation. Interlobular septal thickening and pleural effusion are frequently associated.

• Clinical and Experimental Pediatrics
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• 제48권4호
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• pp.438-442
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• 2005

우리나라에서는 아직 마이코플라스마 폐렴이 가와사키병에 병발한 경우가 보고된 적이 없으며 마이코플라스마 폐렴의 특성상 다양한 호흡기 외의 증상이 비교적 흔하게 동반되는 점 등을 고려할 때, 적절한 치료에도 불구하고 지속되는 발열을 보이는 마이코플라스마 폐렴의 경우 반드시 비전형적 가와사키병이 감별되어야 할 것이며, 이미 언급한 바와 같이 초항원(superantigen)에 근거해 가와사키병의 병태생리를 규명하고자 하는 연구들을 지지할 수 있는 또 하나의 근거로 생각되어 본 증례를 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제62권3호
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• pp.227-231
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• 2007

여러 원인균에 의하여 이차성 기질화 폐렴이 발생할 수 있는데, 감염에 대한 활동성의 염증반응이 진행하여 폐포내의 섬유질의 삼출물이 기질화 됨으로서 발생한다. 아급성으로 발생한 기침, 객담, 발열 등을 주소로 내원한 평소 건강하게 지내던 37세 남자에서, 기관지 내시경과 경피 폐세침 흡인생검을 통하여 기관지 방선균증에 동반된 이차성 기질화 폐렴을 진단하고 치료하였다. 방선균증이 이차성 기질화 폐렴의 원인이 될 수 있음을 본 증례는 보여주고 있다.

• Tuberculosis and Respiratory Diseases
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• 제68권4호
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• pp.205-211
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• 2010

Background: Procalcitonin is a well known marker in infection that plays a role in distinguishing between bacterial and viral infections in screening. The aim of the present study was to evaluate the role of procalcitonin in differentiating between 2009 H1N1 influenza pneumonia and community acquired pneumonia of bacterial origin, or mixed bacterial origin and 2009 H1N1 influenza infection. Methods: A retrospective observational study was performed over the 6-month winter period during the 2009 H1N1 influenza pandemic. Ninety-six patient-subjects were enrolled, all of whom had been diagnosed with community acquired pneumonia in emergency department during the study period. On admission, laboratory studies were performed, which included 2009 H1N1 influenza real-time polymerase chain reaction of nasal secretions and procalcitonin on serum; the laboratory values were compared between the study groups. Receiver operating characteristic curve analyses were performed on the resulting data. Results: Compared to those with bacterial or mixed infections (n=62) and bacterial pneumonia with confirmed organisms (n=30), patients with 2009 H1N1 pneumonia (n=34) were significantly more likely to have low procalcitonin levels (p=0.008, 0.001). Using cutoff of value >0.3 ng/mL, the sensitivity and specificity of procalcitonin for detection of patients with confirmed bacterial pneumonia were 76.2% and 60.6%, respectively. A significant difference in procalcitonin was found between 2009 H1N1 pneumonia and pneumonia caused by mixed influenza viral and bacterial infections (0.15 [0.05~0.84] vs. 10.3 [0.05~22.87] ng/mL, p=0.045). Conclusion: Serum procalcitonin measurement may assist in the discrimination between pneumonia of bacterial and of 2009 H1N1 influenza origin. High values of procalcitonin suggest that bacterial infection or mixed infection of bacteria and 2009 H1N1 influenza is more likely.

• Pediatric Infection and Vaccine
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• 제20권2호
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• pp.71-80
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• 2013

목 적 : 이 연구의 목적은 항체 검사를 어느 시기에 검사해야 마이코플라스마 폐렴을 가장 적절하게 진단을 내릴 수 있는지를 파악하기 위함이다. 방 법 : 2011년 6월부터 2011년 10월까지의 한양대학교병원에서 진단받은 206 명의 폐렴 환아들을 대상으로 후향적으로 분석하였다. 결 과 : 마이코플라스마 폐렴으로 진단받은 160명의 평균 연령은 5.4세이었다. 마이코플라스마 간접입자 응집항체의 측정을 위한 혈청 획득 시간은 마이코플라스마 항체가가 1:640 이상인 혈청들과(8.58일) 1:640 미만인 혈청들(5.44일) 사이에서 통계학적으로 유의한 차이가 있었다(P<0.001). 결 론 : 본 연구의 결과는 폐렴 환아에서 증상 시작일로부터 8일 전에 획득한 마이코플라스마 항체가가 음성이면 확진을 위해 반복 검사가 필요한 것으로 보였다. 이 제안으로 마이코플라스마 폐렴에서 최적의 진단을 내릴 수 있게 도움을 줄 수 있을 것이다.

• Clinical and Experimental Pediatrics
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• 제63권7호
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• pp.239-250
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• 2020

The novel coronavirus disease 2019 (COVID-19) is spreading globally. Although its etiologic agent is discovered as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), there are many unsolved issues in COVID-19 and other infectious diseases. The causes of different clinical phenotypes and incubation periods among individuals, species specificity, and cytokine storm with lymphopenia as well as the mechanism of damage to organ cells are unknown. It has been suggested that in viral pneumonia, virus itself is not a direct cause of acute lung injury; rather, aberrant immune reactions of the host to the insults from viral infection are responsible. According to its epidemiological and clinical characteristics, SARS-CoV-2 may be a virus with low virulence in nature that has adapted to the human species. Current immunological concepts have limited ability to explain such unsolved issues, and a presumed immunopathogenesis of COVID-19 is presented under the protein-homeostasis-system hypothesis. Every disease, including COVID-19, has etiological substances controlled by the host immune system according to size and biochemical properties. Patients with severe pneumonia caused by SARS-CoV-2 show more severe hypercytokinemia with corresponding lymphocytopenia than patients with mild pneumonia; thus, early immunomodulator treatment, including corticosteroids, has been considered. However, current guidelines recommend their use only for patients with advanced pneumonia or acute respiratory distress syndrome. Since the immunopathogenesis of pneumonia may be the same for all patients regardless of age or severity and the critical immune-mediated lung injury may begin in the early stage of the disease, early immunomodulator treatment, including corticosteroids and intravenous immunoglobulin, can help reduce morbidity and possibly mortality rates of older patients with underlying conditions.