• Title/Summary/Keyword: Pulmonary infection

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Host-Pathogen Interactions Operative during Mycobacteroides abscessus Infection

  • Eun-Jin Park;Prashanta Silwal;Eun-Kyeong Jo
    • IMMUNE NETWORK
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    • v.21 no.6
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    • pp.40.1-40.20
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    • 2021
  • Mycobacteroides abscessus (previously Mycobacterium abscessus; Mabc), one of rapidly growing nontuberculous mycobacteria (NTM), is an important pathogen of NTM pulmonary diseases (NTM-PDs) in both immunocompetent and immunocompromised individuals. Mabc infection is chronic and often challenging to treat due to drug resistance, motivating the development of new therapeutics. Despite this, there is a lack of understanding of the relationship between Mabc and the immune system. This review highlights recent progress in the molecular architecture of Mabc and host interactions. We discuss several microbial components that take advantage of host immune defenses, host defense pathways that can overcome Mabc pathogenesis, and how host-pathogen interactions determine the outcomes of Mabc infection. Understanding the molecular mechanisms underlying host-pathogen interactions during Mabc infection will enable the identification of biomarkers and/or drugs to control immune pathogenesis and protect against NTM infection.

A Case of Pulmonary Nocardiosis in the Patient with Cushing's Disease (쿠싱병에 동반된 폐 노카르디아증 1예)

  • Lee, So-Young;Oh, Yeon Mok;Lim, Chae-Man;Lee, Sang Do;Koh, Younsuck;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.1
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    • pp.61-65
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    • 2004
  • Even though nocardiosis is one of opportunistic infections, and can occur in Cushing's syndrome, it rarely occurs in patients with Cushing's disease. Herein, a case with Cushing's disease in whom nocardiosis had manifested as a pulmonary lesion, which after percutaneous needle aspiration, empyema and a breast abscess were also noted.

Infection Control in Pulmonary Function Laboratories in Domestic Hospitals (국내 의료기관의 폐기능검사실에서 감염관리 실태조사)

  • Nan-Hee LEE;Suhng Wook KIM
    • Korean Journal of Clinical Laboratory Science
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    • v.55 no.3
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    • pp.143-150
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    • 2023
  • The global outbreak of COVID-19 has underscored the pressing need for robust infection control practices in pulmonary function laboratories (PFL). However, the existing guidelines and regulatory frameworks provided by relevant authorities in the country have revealed certain deficiencies in effectively addressing this significant public health crisis. This study surveyed the infection control regulations, disposable item usage, ventilation facilities, spatial separation, and the configuration of entrance doors in 51 domestic hospital facilities from Oct 1, 2021, to Nov 2, 2021. The survey findings revealed that while there was a relatively satisfactory adherence to airborne, droplet, and contact precautions with adequate awareness and utilization of personal protective equipment, the environmental disinfection practices exhibited a suboptimal performance rate of 39.22% per patient. Depending on the specific survey domains, substantial variations were observed in the utilization of disposable items (81.05%), ventilation systems (45.75%), dedicated testing spaces (80.39%), separation of administrative areas (15.69%), and the installation of automated doors (19.61%). This study not only highlights the paramount importance of infection control in PFLs within domestic medical institutions but also provides foundational data for developing and enhancing standardized guidelines that align with international benchmarks for infection control in these settings.

$Mycoplasma$ $pneumoniae$ pneumonia in children

  • Youn, You-Sook;Lee, Kyung-Yil
    • Clinical and Experimental Pediatrics
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    • v.55 no.2
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    • pp.42-47
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    • 2012
  • $Mycoplasma$ $pneumoniae$ (MP), the smallest self-replicating biological system, is a common cause of upper and lower respiratory tract infections, leading to a wide range of pulmonary and extra-pulmonary manifestations. MP pneumonia has been reported in 10 to 40% of cases of community-acquired pneumonia and shows an even higher proportion during epidemics. MP infection is endemic in larger communities of the world with cyclic epidemics every 3 to 7 years. In Korea, 3 to 4-year cycles have been observed from the mid-1980s to present. Although a variety of serologic assays and polymerase chain reaction (PCR) techniques are available for the diagnosis of MP infections, early diagnosis of MP pneumonia is limited by the lack of immunoglobulin (Ig) M antibodies and variable PCR results in the early stages of the infection. Thus, short-term paired IgM serologic tests may be mandatory for an early and definitive diagnosis. MP infection is usually a mild and self-limiting disease without specific treatment, and if needed, macrolides are generally used as a first-choice drug for children. Recently, macrolide-resistant MP strains have been reported worldwide. However, there are few reports of apparent treatment failure, such as progression of pneumonia to acute respiratory distress syndrome despite macrolide treatment. The immunopathogenesis of MP pneumonia is believed to be a hyperimmune reaction of the host to the insults from MP infection, including cytokine overproduction and immune cell activation (T cells). In this context, immunomodulatory treatment (corticosteroids or/and intravenous Ig), in addition to antibiotic treatment, might be considered for patients with severe infection.

Impaired Expression of MAPK Is Associated with the Downregulation of TNF-${\alpha}$, IL-6, and IL-10 in Mycobacterium abscessus Lung Disease

  • Sim, Yun-Su;Kim, Su-Young;Kim, Eun-Joo;Shin, Sung-Jae;Koh, Won-Jung
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.3
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    • pp.275-283
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    • 2012
  • Background: Healthy individuals who develop nontuberculous mycobacteria (NTM) lung disease are likely to have specific susceptibility factors which can lead to a NTM infection. The aim of the present study was to investigate the mechanism underlying innate immune responses, including the role of mitogen-activated protein kinase (MAPK), in Mycobacterium abscessus lung disease. Methods: Extracellular signal-regulated kinase (ERK1/2) and p38 MAPK expression in monocytes from peripheral blood mononuclear cells were measured by Western blot analysis after stimulation by Mycobacterium avium in five patients with M. abscessus lung disease and seven healthy controls. A M. avium-induced cytokine assay was performed after inhibition of ERK1/2 and p38 MAPK pathways. Results: Mycobacterium avium induced p38 and ERK1/2 expression in monocytes from healthy controls and subsequently upregulated tumor necrosis factor (TNF)-${\alpha}$, interleukin (IL)-6, and IL-10 production. In monocytes from patients with M. abscessus lung disease, however, induction of p38 and ERK1/2 expression, and the production of TNF-${\alpha}$, IL-6, and IL-10 were significantly lower. Conclusion: Decreased activity of MAPK and cytokine secretion in monocytes from patients with M. abscessus lung disease may provide an explanation regarding host susceptibility to these uncommon infections.

Lobectomy in Pulmonary Infections in Chronic Granulomatous Disease of Childhood -A Case Report- (소아기의 만성 육아종성 질환의 폐감염시 시행한 폐엽절제술 -1례 보고-)

  • 한재열;원태희;원용순;최수승
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1102-1105
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    • 1998
  • Chronic granulomatous disease in childhood is a rare inheritable disorder of phagocytic cells in which defective production of the reactive intermediates of oxygen predisposes the patient to severe recuring pyogenic infections. The lung is the most common site of infection and pulmonary disease is the primary cause of death for greater than 50% of children with chronic granulomatous disease. Although the role of surgery in management of this disease remains undefined, rapid diagnosis of the underlying pulmonary problem is crucial to determine the most appropriate antimicrobial therapy and surgical techniques such as lobectomy of involved areas lead to more rapid recovery and thus allow the antibiotics to be more efficacious in these cases. We have treated a one month old male baby who had the chronic granulomatous disease with pulmonary infection. Wide surgical resection of the affected lobe and use of antibiotics and antifungals were carried out with good clinical results. He was well after the operation.

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A Case of Pseudomembranous Necrotizing Bronchial Aspergillosis in An Old Age Host (노인 환자에서 발생한 거짓막 괴사성 기관지 아스페르길루스증 1예)

  • Lee, Seung Eun;Jun, Eun Ju;Song, Ju Han;Shin, Jong Wook;Kim, Jae Yeol;Park, In Whon;Choi, Byoung Whui;Choi, Jae Chol;Kim, Mee Kyoung
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.3
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    • pp.278-282
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    • 2007
  • Invasive aspergillus tracheobronchitis is uncommon manifestation of infection due to Aspergillus species, occurring in severely immunocompromised patients who are generally neutropenic with haematological diseases, AIDS, or after heart and lung transplantation. The pseudomembranous form is the most severe condition and is usually fatal despite treatment with antifungal agents. However, there are a few cases reported with no apparent severe compromise in the host defences. We encountered a pseudomembranous necrotizing bronchial aspergillosis in a 73-year old male patient, who was treated successfully with antifungal agents.

A Case of Mycobacterium abscessus Lung Disease in a Patient with H1N1 Influenza Pneumonia (H1N1 Influenza 폐렴 환자에서 발생한 Mycobacterium abscessus 감염 1예)

  • Jung, Kyoung-Won;Yu, Hoon;Lee, Tae-Hoon;Kwon, O-Sung;Choi, Suk-Won;Kang, Se-Hun;Shim, Tae-Sun;Kim, Dong-Soon;Song, Jin-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.3
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    • pp.207-211
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    • 2010
  • Novel influenza A (H1N1) virus is a common pathogen of febrile respiratory infection recently. Here, we report the case of a 63-year-old male patient who presented with 3 days' ongoing cough and fever. He was diagnosed with novel influenza A (H1N1) pneumonia by real-time reverse-transcriptase-polymerase-chain-reaction (rRT-PCR). During treatment for novel influenza A (H1N1), his symptoms and radiologic findings improved initially, but multiple lung nodules developed subsequently and found on chest x-ray (on the 5th hospital day). Mycobacterium abscessus was isolated repeatedly from sputum and bronchoalveolar lavage fluid. To our knowledge, this is the first reported case of Mycobacterium abscessus lung disease in a patient with H1N1 influenza pneumonia.

A Case of the Bronchial Artery-Pulmonary Vein Malformation (기관지동맥-폐정맥의 동정맥기형 1예)

  • Yoo, Tae-Seok;Jo, Young-Il;Heo, Weon-Man;Jin, Choon-Jo;Song, Kwang-Seon;Yong, Suk-Joong;Shin, Kye-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.767-771
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    • 1995
  • The bronchial artery-pulmonary vein malformation should be called the systemic artery-to-pulmonary vein arterioveonus malformation in the lung. Although pulmonary arteriovenous malformation has been well documented in intrapulmonary arteriovenous malformation, the systemic artery-to-pulmonary vein arteriovenous malformation is rare. Most patients with systemic artery-to-pulmonary vein arteriovenous malformation is asymptomatic and the diagnosis of these anomaly may be done by continuous murmur or abnormal chest X-ray on the physical examination. The pathogenesis of this condition is congenital malformation which explains these anastomoses between the pulmonary vein and accessory brachial arteries and acquired malformation which explains development of new blood vessel to supply large enough to cause significant systemic-pulmonary shunts due to inflammation secondary to infection, trauma, or previous surgery. We experienced a case of the bronchial artery-pulmonary vein malformation which was detected on angiography in 20-year-old women whose chief complain is hemoptysis. This massive hemoptysis was controlled by selective brachial artery embolization with Gelfoam and Ivalon particles.

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Surgical Techniques of Right Lung Transplantation in Dogs (황견에서 우측폐 이식수술기에 관한 실험적 연구)

  • 이두연
    • Journal of Chest Surgery
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    • v.22 no.3
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    • pp.416-424
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    • 1989
  • We have performed eight, single transplantations of right lung in dogs from September, 1988 to March 1989 at the Thoracic & Cardiovascular Surgical department, Yonsei University, College of Medicine, Seoul, Korea. We wrapped bronchial anastomosis site with great omentum and used cyclosporin in preoperative and postoperative periods in seven cases except one. The one without wrapping the bronchial anastomotic site with omentum and using cyclosporin died due to bronchial anastomotic site rupture in postoperative fourth day. If there is no reason to choose one side over the other, we would generally choose to do left-sided transplant as this is technically somewhat easier because of the long length of recipient bronchus and the ease of clamping the left atrium proximal to the pulmonary veins. The right atrium limits the amount of left atrium that can have incorporated into the clamp proximal to the pulmonary veins on the right side. But we had chosen to do right-sided transplant of lung because we must take variable technical experiences on right sided lung transplant in dogs. We have to anastomose one of pulmonary vein and left atrial wall on right-sided transplant easily only with double ligation of one pulmonary vein because right atrium limited the clamp of left atrium proximal to pulmonary veins with decreased venous return and cardiac output in some dogs. All seven dogs with right-sided lung transplant had survived more than one day with good condition except one. The one dog have to be sacrificed to evaluate the difference between the gas analysis in pulmonary venous and arterial blood in post-operative eight hours. We found hemorrhagic pulmonary edematous changes of contralateral left lung in this dog. And also all dogs have to be sacrificed for the evaluation of surgical problems, anytime in post-operative periods without any cardiopulmonary resuscitative efforts when the general condition would be worse progressively. We found no any surgical technical errors in seven dogs except one with thrombi in suture site of left atrium. There were hemorrhagic pulmonary edematous changes of transplanted right lung in one, of contralateral left lung in one, of contralateral left lung with double ligation of its pulmonary artery in one, thrombi around left atrial sutures sites in one, multiple air leakage in one bronchial rupture in one due to rejection or infection. There were accidental extubation and delayed intubation in one and unknown cause of death in one.

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