• Journal of Chest Surgery
• /
• 제23권6호
• /
• pp.1221-1224
• /
• 1990

Fifty -six cases of tuberculous peripleural abscess were experienced in the department of thoracic and cardiovascular surgery, college of medicine, Hallym university from January 1980 to June 1990. Tuberculous peripleural abscess seems to originate from the space between the parietal pleura and endothoracic fascia. But rib caries, originated by hematogenous spread of mycobacteria to the rib, shows the rib destruction first, thereafter periosteal erosion and regional tissue involvement follows. In our 56 cases, results were as follows: 1. Their age ranged from 6 to 82 years, and female dominant [M: F=21: 35]. 2. The locations of abscess were 31 right, 23 left, and 2 sternal portions. 3. On X \ulcornerray findings, 37 cases showed active or old lesion of the tuberculosis in the lung field, 7 cases periosteal destruction of the ribs, and 29 cases pleural thickening. 4. Operative findings showed cold abscess with multiple fistulous tracts leading to intercostal space in most of the cases, and their origin were presumed to be from the space between the endothoracic fascia and parietal pleura. 5. The pus showed negative AFB stain in most of the cases except 3 cases. 6. Partial costectomy and radical curettage with drainage were performed in all cases. 7. 7 cases recurred after the first operations, but no recurrence after second operations.

• Tuberculosis and Respiratory Diseases
• /
• 제46권1호
• /
• pp.142-146
• /
• 1999

A 55-year-old-female was admitted for the evaluation of mass shadow on chest film. She complained of fever, chilling, cough, and whitish sputum. She did not give any history of choking or coughing when she ate. The chest CT showed lung aoocess in right lower lobe with extension of infiltration and air shadow in mediastinum. The esophagoscopy and esophagography were performed to find the cause of mediastinal infiltration, and bronchoesophageal fistula was detected in esophagography. The patient complained of severe chilling and febrile sensation after esophagography, mediastinitis aggravated by thin barium was suggested clinically. So, surgical drainage of lung abscess and thin barium was done urgently. One month after operation, follow-up of esophagoscopy and esophagography were done, the bronchoesophageal fistula was not detected.

• Tuberculosis and Respiratory Diseases
• /
• 제77권4호
• /
• pp.188-192
• /
• 2014

We present a case of an unusual infectious complication of a ruptured mediastinal abscess after endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), which led to malignant pleural effusion in a patient with stage IIIA non-small-cell lung cancer. EBUS-TBNA was performed in a 48-year-old previously healthy male, and a mediastinal abscess developed at 4 days post-procedure. Video-assisted thoracoscopic surgery was performed for debridement and drainage, and the intraoperative findings revealed a large volume pleural effusion that was not detected on the initial radiographic evaluation. Malignant cells were unexpectedly detected in the aspirated pleural fluid, which was possibly due to increased pleural permeability and transport of malignant cells originating in a ruptured subcarinal lymph node from the mediastinum to the pleural space. Hence, the patient was confirmed to have squamous cell lung carcinoma with malignant pleural effusion and his TNM staging was changed from stage IIIA to IV.

• Tuberculosis and Respiratory Diseases
• /
• 제42권1호
• /
• pp.110-114
• /
• 1995

저자등은 26세 남자환자에서 폐농양과 동반된 속발성 비대성 골관절병증 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
• /
• 제42권5호
• /
• pp.777-780
• /
• 1995

살모넬라의 위장관 감염은 잘알려져 있으나 국소감염은 흔하지 않다. 저자들은 폐암으로 3차례의 항암제 치료을 받던 환자의 총상부위에서 농양이 발생되어 배양결과 salmonella group D가 동정된 1예를 경험하여 문헌과 함께 보고하는 바이다.

• The Korean Journal of Medicine
• /
• 제99권1호
• /
• pp.50-56
• /
• 2024

Nocardiosis is uncommon. Immunocompromising conditions predispose individuals to pulmonary and disseminated nocardiosis of the brain, skin, and subcutaneous tissues. The most common pathogens are Nocardia cyriacigeorgica, Nocardia nova, and Nocardia farcinica. The speciation of Nocardia to determine antimicrobial susceptibility is difficult using traditional biochemical methods. Here, we report the case of a 73-year-old man with chronic obstructive lung disease who developed a rapidly progressing intramuscular abscess around the left hip and thigh. Within 3 days, the lesions progressed to an epidural abscess at the L4 to S1 level. Although he was treated with broad-spectrum antibiotics and extensive incision and drainage, he died of rapidly progressive respiratory failure. Nocardia abscessus (N. abscessus) was identified in pus samples using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). This case shows that the diagnosis of an intramuscular abscess caused by N. abscessus is challenging and that using MALDI-TOF MS may facilitate the diagnosis and ensure appropriate treatment.

• Tuberculosis and Respiratory Diseases
• /
• 제40권2호
• /
• pp.158-164
• /
• 1993

연구배경 : 최근에는 폐농양이 기저질환이 있는 환자들에서 많이 발생함에 따라 내과적 치료의 실패율이 증가하고 폐절제술도 시행하기 어려운 경우가 많아 폐농양으로 인한 사망률이 오히려 증가하는 경향이 있으며 또한 거대한 공동의 폐농양 환자에서는 치명적인 합병증이 우려되어 이들에 있어서는 보다 적극적인 치료가 요구되어지고 있다. 저자들은 이러한 환자들에서 경피적 배농을 시행하여 그 치료 효과를 알아보고자 하였다. 방법 : 내과적 치료에 반응이 없거나 치명적인 합병증이 우려되는 거대한 폐농양이 있는 9예를 대상으로 하여 경피적 배농술을 시행하였고 경피적 배농은 8.3F pig-tail 카테타를 투시하여 Seldinger 방법을 이용하여 삽입하였다. 이와 함께 고식적 내과 치료만을 한 폐농양 환자 10예를 대조군으로 하여 치료 효과 및 합병증 등을 비교 검토하였다. 결과 : 고식적인 내과적 치료만을 시행한 군에서는 평균 8.7일에 임상적 호전을 보였으나 카테타 배농을 시행한 군에서는 평균 1.8일에 임상적 호전이 있었다. 그리고 경피적 배농시의 카테타 배농기간은 평균 13.2일이었다. 사망한 예는 대조군에서는 대량 객혈과 농에 의한 질식 그리고 패혈증 등으로 사망한 3예가 있었고 경피적 배농을 실시한 군에서는 간성혼수와 패혈증으로 사망한 2예가 있었다. 경피적 배농술에 따른 폐장 및 흉막 합병증은 없었으며 카테타 폐쇄와 전위 등의 기능부전 2예가 있었다. 결론: 경피적 배농술은 내과적 치료에 효과가 없는 경우와 거대한 폐농양 환자에서 비교적 안전하게 시도될 수 있는 효과적인 치료법이라 생각된다.

• The Korean Journal of Pain
• /
• 제14권2호
• /
• pp.257-260
• /
• 2001

It is well known that bronchogenic carcinoma frequently metastasize to bony skeleton, although it is unusual for it to metastasize to soft tissue in the form of a musculoskeletal abscess. We report a bronchogenic cancer patient presenting with back pain after undergoing a celiac plexus block. Magnetic resonance imaging (MRI) demonstrated inflammation with an abscess of the paraspinal muscle from T12 to L5; however, it was subsequently diagnosed as a metastatic pleomorphic carcinoma by histopathological study.

• Journal of Chest Surgery
• /
• 제6권2호
• /
• pp.171-174
• /
• 1973

A case of pulmonary aspergillosis, strongly suspected before operation and confirmed after surgical intervention, was reviewed with related literatures. It has become to be a well recognized fact that pulmonary mycosis generally results from sapro-phytic colonization of previous lung cavities usually due to pulmonary tbc, lung abscess, cyst of bronchiectasis. Recently, the author experienced one case of pulmonary aspergillosis which had been diagnosed and treated as tuberculosis for 6 years. Sputum culture, immunologic study and X-ray findings constitute essential part of diagnosis. Surgical resection is the treatment of choice combined with systemic administration of anti-fungal agents to eradicate the disease completely.

• Journal of Chest Surgery
• /
• 제19권4호
• /
• pp.731-735
• /
• 1986

Atelectasis with chronic pneumonitis affecting the right middle lobe secondary to compression of the middle lobe bronchus by enlarged indurated or calcified peribronchial nodes is defined as middle lobe syndrome clinicopathologically. The lesion in this series of case reports including tuberculous lymphadenitis, lung cancer, atelectasis and lung abscess with organizing pneumonitis, had been treated by lobectomy. Postoperative courses were uneventful in all patients. Herewith, we report these four experiences with review of literature.