• 제목/요약/키워드: Pulmonary Tuberculosis

검색결과 2,235건 처리시간 0.03초

결핵성 림프절염 치료 후 발생한 사르코이드증 1예 (Sarcoidosis Occured after Treatment of Tuberculous Lymphadenitis)

  • 이효정;윤선영;한지민;안지현;이정주;최창민;오연목;심태선;이상도;김우성;김동순;송진우
    • Tuberculosis and Respiratory Diseases
    • /
    • 제70권5호
    • /
    • pp.433-437
    • /
    • 2011
  • Sarcoidosis is a multisystemic disorder characterized by the presence of non-caseating granulomas in the involved organ. Tuberculosis is an infectious disease caused by $Mycobacterium$ $tuberculosis$ and is characterized by granuloma with caseous necrosis. The clinical and histological similarity between sarcoidosis and tuberculosis has stimulated research searching for an association between mycobacterium and sarcoidosis. We report a case of a 38-year-old male with sarcoidosis that developed soon after treatment of tuberculous lymphadenitis. He was diagnosed as tuberculous lymphadenitis by microbiological confirmation. He showed clinical improvement after treatment for tuberculosis. One year later, his chest radiography showed bilateral hilar enlargement with diffuse bilateral nodules. A noncaseating granuloma was confirmed by endobronchial ultrasound guided transbronchial needle aspiration and he was diagnosed with sarcoidosis. To our knowledge, this is the first report describing sarcoidosis after treatment of tuberculosis in South Korea.

객담 도말 양성 환자에서 폐결핵과 비결핵 항산균 폐질환의 구별을 위한 결핵균 PCR 검사의 유용성 (Usefulness of PCR Test for M. tuberculosis for the Differentiation of Pulmonary Tuberculosis and Nontuberculous Mycobacterial Lung Disease in Patients with Smear-Positive Sputum)

  • 유창민;고원중;류연주;전경만;최재철;강은해;서지영;정만표;김호중;권오정;이장호;기창석;이남용
    • Tuberculosis and Respiratory Diseases
    • /
    • 제57권6호
    • /
    • pp.528-534
    • /
    • 2004
  • 배 경 : 객담 항산균 도말 검사는 저렴하고 간편한 검사이며, 검사 결과를 빨리 얻을 수 있다는 장점이 있지만, 결핵균과 NTM을 구별하지 못한다는 제한점이 있다. 외국에서는 도말 양성 환자에서 폐결핵과 NTM 폐질환을 구별하기 위하여 TB-PCR 검사가 권장되고 있다. 본 연구는 국내에서도 객담 도말 양성 환자에서 객담 또는 기관지 세척액의 TB-PCR 검사가 폐결핵과 NTM 감염의 감별 진단에 유용한가를 알아보고자 하였다. 대상 및 방법 : 2003년 1월 1일부터 2003년 12월 31일까지 1년간 진단검사의학과 임상미생물검사실로 항산균 도말 및 배양검사가 의뢰된 객담 검체 중 도말과 배양이 모두 양성인 826건의 객담 검체를 연구대상으로 하였고, 이 검체가 분리된 환자 299명의 의무기록과 방사선학적 소견을 후향적으로 조사하였다. 결 과 : 결핵균이 분리된 객담은 606건(73.4%)이었고 NTM이 분리된 객담은 220건(26.6%)이었다. 299명의 환자 중 결핵균이 분리된 폐결핵 환자는 229명(76.6%)이었고, NTM이 분리된 환자는 70명(23.4%)이었으며 모두 임상적 의의가 있는 NTM 폐질환 환자였으며, 원인균은 M. avium complex 38명(54.3%), M. abscessus 26명(37.1%), 기타 6명 등이었다. 폐결핵 환자 229명 중 112명(48.9%)와 NTM 폐질환 환자 70명 중 51명 (72.9%)에서 객담 또는 기관지 세척액을 이용한 TB-PCR 검사가 시행되었다. 검사를 시행한 폐결핵 환자 112명 중 99명(88.4%)에서 TB-PCR 검사가 양성을 보였고, NTM 폐질환 환자는 모두 음성을 보였다 (p<0.001). 객담 도말 양성 환자에서 객담 또는 기관지 세척액의 TB-PCR 검사 양성 반응이 폐결핵을 예측하는 민감도와 특이도는 각각 88.4%(99/112)와 100%(51/51)였고, 양성 예측치는 100%(99/99) 그리고 음성 예측치는 79.7%(51/64)였다. 결 론 : 객담 항산균 도말 양성을 보이는 환자에서 객담 또는 기관지 세척액 TB-PCR 검사는 국내에서도 폐결핵과 NTM 폐질환을 구별하는데 임상적 유용성이 있을 것으로 사료된다.

Pulmonary Actinomycosis 의 1 치험례 (Pulmonary Actinomycosis: A Case Report)

  • 곽동선;이성광;박동식
    • Journal of Chest Surgery
    • /
    • 제6권1호
    • /
    • pp.23-28
    • /
    • 1973
  • This is a report of pulmonary actinomycosis which has been treated with long chemotherapy under the misdiagnosis of pulmonary tuberculosis for 14 years and has finally diagnosed by the specimens of excised lung. Pulmonary actinomycosis is very few in recent report by the use of penicillin and sulfonamide, but for the difficult differential diagnosis with pulmonary tuberculosis and carcinoma, It is a choice of treatment for resect for the localized lesions.

  • PDF

폐결핵 치료의 외과적 요법에 대한 임상적 고찰 (A Clinical Review of the Surgical Treatment for Pulmonary tuberculosis)

  • 신철식;조효규;장동철;김영준;고석신;송선대
    • Tuberculosis and Respiratory Diseases
    • /
    • 제38권3호
    • /
    • pp.245-249
    • /
    • 1991
  • Surgical intervention for pumlmonary tuberculosis has been controverted for last several decades. Although it is widely held that the chemotherapy is the best modality for treatment of pulmonary tuberculosis, surgical intervention has still some roles in well elected circumstance. At the National Kongju Tuberculosis Hospital in Korea, we performed a retrospective case Cohort study through the regular follow-up of 463 cases, who underwent the surgical intervention for pulmonary tuberculosis between January 1986 and April 1990. The results were as follows: 1) The male to female ratio was 1.8:1 and 84.4% of the patients were between 20 and 49 years of age. 2) According to the NAT classification, 6 cases (1.3%) were minimal, 216 (46.7%) moderately advanced and 241 (52%) far advanced. 3) One hundred and thirty four cases (28.9%) had the treatment history of 5 to 10 years and 129 cases (27.9%) of 3 to 4 years. 4) As for the pathologic entities, 172 cases (37.1%) had the totally destroyed lung and 137 (29.6%) destroyed lobe or segment. 5) A total of 238 cases (51.4%) underwent pneumonectomy and 153 (33.0%) lobectomy. 6) As the post-operative complications, 21 cases (4.5%) had empyema and 11 (2.4%) bleeding. The rate of complication after pneumonectomy and lobectomy was 5.8% and 3.2%, respectively. 7) Six cases (1.3%) died post-operatively. 8) Out of 238 cases with pre-operative positivity for AFB, 212 achieved the negative conversion, its rate being 89.1%. It follows from these results that although it has a limit, surgical intervention may play an important role in treating some patients with pulmonary tuberculosis.

  • PDF

폐결핵 환자의 지지체계와 낙인감 및 자가간호 수행도 (Support System, Stigma and Self-Care Behaviors in Patients with Pulmonary Tuberculosis)

  • 박은하;최소은
    • Journal of Korean Biological Nursing Science
    • /
    • 제22권4호
    • /
    • pp.288-296
    • /
    • 2020
  • Purpose: The purpose of this descriptive study was to identify factors influencing pulmonary tuberculosis patients' self-care behaviors. Methods: The patients were 125 adults over the age of 19 who were diagnosed with pulmonary tuberculosis, receiving care at the National tuberculosis hospital. The survey questions measured family support, multidimensional scale of perceived social support (MSPSS), stigma and self-care behaviors. Results: The average score for self-care behaviors was 3.91, ranging from 2.22 to 5.00. There was a significant positive correlation between self-care behaviors and support system. There was a significant negative correlation between self-care behaviors and stigma. The significant variables influencing self-care behaviors were family support (β = .33, P< .001), smoking (β= -.23, p= .002), age (β= .22, p= .005) and experience of stopping treatment (β= -.17, p= .040). These factors explain 36% of pulmonary tuberculosis patients' self-care behaviors. Conclusion: Family support is very important to improve selfcare for tuberculosis patients. However, those in their fifties, men, and those who do not have a job and have underlying diseases have low family support, so they need active support at the national level. The study results suggest that a educational and nursing programs must be designed to reduce stigma and promote support system in order to enhance self-care behaviors.

폐결핵에 병발된 폐 Aspergilloma (Pulmonary Aspergilloma Associated Pulmonary Tuberculosis)

  • 심성보
    • Journal of Chest Surgery
    • /
    • 제24권10호
    • /
    • pp.1011-1018
    • /
    • 1991
  • From September, 1985 to March, 1991, 33 patients under went thoracotomy for treatment of pulmonary aspergilloma with Pulmonary tuberculosis on the department of Thoracic and Cardiovascular Surgery, National Kongju Hospital. 1. There were 25 male and 8 female patients ranging from 19 to 57 years old [mean age, 36.2 years]. 2. Hemoptysis was the most common symptom [recurrent minor hemoptysis: 24cases, severe hemoptysis [200cc /day]: 4 cases, massive hemoptysis [600/day]: 4 cases]. 3. In the chest X-ray films, intracavitary fungus balls [air meniscus sign] were noted in 20 cases [61%] and upper lobe involvements were 29 cases [88%]. 4. All cases had a history of treatment with antituberculosis drugs under diagnosis of pulmonary tuberculosis for an average of 10 years and 2 months. 5. The most common indication for operation was hemoptysis [32 cases] - hemoptysis with total destroyed lung or lobe: 12cases, hemoptysis with open AFB [t-] cavity: 6cases, recurrent or massive hemoptysis: 14 cases. 6. The operative procedures was as follows - - - lobectomy . 16 cases, pneumonectomy: 8 cases, bilobectomy, segmentectomy, cavernoplasty and lobectomy with segmentectomy: each 2 cases, lobectomy with cavernoplasty: 1 case. 7. 6 complications appeared postoperatively which included empyema with BPF [2 cases], empyema [2 cases] and wound infection [2 cases]. In conclusion, surgical resection is the treatment of choice in the management of pulmonary aspergilloma associated pulmonary tuberculosis.

  • PDF

속립성 결핵 환자에서 기관지 폐포 세척액 소견 (Differential Cell Analysis and Lymphocyte Subset Analysis in Bronchoalveolar Lavage Fluid from Patients with Miliary Tuberculosis)

  • 김지은;설희윤;조우현;김기욱;전두수;박혜경;김윤성;이민기;박순규
    • Tuberculosis and Respiratory Diseases
    • /
    • 제68권4호
    • /
    • pp.218-225
    • /
    • 2010
  • Background: Bronchoalveolar lavage (BAL) is a useful technique to recover lower airway fluid and cells involved in many respiratory diseases. Miliary tuberculosis is potentially lethal, but the clinical manifestations are nonspecific and typical radiologic findings may not be seen until late in the course of disease. In addition, invasive procedures are often needed to confirm disease diagnosis. This study analyzed the cells and the T-lymphocyte subset in BAL fluid from patients with miliary tuberculosis to determine specific characteristics of BAL fluid that may help in the diagnosis of miliary tuberculosis, using a less invasive procedure. Methods: On a retrospective basis, we enrolled 20 miliary tuberculosis patients; 12 patients were male and the mean patient age was $40.5{\pm}16.2$ years. We analyzed differential cell counts of BAL fluid and the T-lymphocyte subset of BAL fluid. Results: Total cells and lymphocytes were increased in number in the BAL fluid. The percentage of CD4+ Tlymphocytes and the CD4/CD8 ratio in BAL fluid were significantly decreased and the percentage of CD8+ T-lymphocytes was relatively higher. These findings were more prominent in patients infected with the human immunodeficiency virus (HIV). In the HIV-infected patients, the proportion of lymphocytes was significantly higher in BAL fluid than in peripheral blood. There were no significant differences between the BAL fluid and the peripheral blood T-lymphocytes subpopulation. Conclusion: BAL fluid in patients with miliary tuberculosis demonstrated lymphocytosis, a lower percentage of CD4+ T-lymphocytes, a higher percentage of CD8+ T-lymphocytes, and a decreased CD4/CD8 ratio. These findings were more significant in HIV-infected subjects.