• Title/Summary/Keyword: Skin Diagnosis

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A Case of Pneumonia with Septic Shock Due to Nocardia farcinia in Liver Transplant Patient (간이식 환자에서 발생한 Nocardia farcinia 폐렴 및 패혈성 쇼크 1예)

  • Lee, Su-Hwan;Park, Byung-Hoon;Son, Ji-Young;Jung, Ji-Ye;Kim, Eun-Young;Lim, Ju-Eun;Lee, Ji-Hoon;Hyun, Shin-Young;Lee, Sang-Hoon;Lee, Sang-Kook;Kim, Song-Yee;Lee, Kyung-Jong;Kang, Young-Ae;Kim, Young-Sam;Kim, Se-Kyu;Chang, Joon;Seo, You-Kyung;Lee, Kyoung-Won;Park, Moo-Suk
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.6
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    • pp.469-473
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    • 2010
  • Nocardia farcinia, an aerobic, gram-positive bacilli actinomycetes of the genus Nocardia, is an uncommon pathogen found in humans. The most common Nocardia infection sites are the lung, central nervous system, and skin. Even though hematogenous dissemination can occur, isolation of the organism from blood cultures is very rare. We report a case of Nocardia infection that was isolated on blood cultures. A 59-year-old male with a medical history that includes a liver transplantation 6-years prior due to hepatocellular carcinoma secondary to chronic hepatitis B, developed pneumonia and was transferred to Severance Hospital. At the time of admission, the patient's initial exam showed hypothermia, tachypnea, and hypotension. His chest radiograph showed severe pneumonia and a large abscess on left upper lobe. Under the presumptive diagnosis of bacterial pneumonia or other opportunistic infection, we started broad spectrum antibiotics. However, he developed Nocardia sepsis, rapidly deteriorated, and subsequently died.

Infection Rate of Chlamydia pneumoniae in Patients with Chronic Cough (만성기침 환자에서 Chlamydia pneumoniae 감염률)

  • Chun, Seung-Yeon;Park, Kwon-Oh;Park, Yong-Bum;Choi, Jeong-Hee;Lee, Jae-Young;Mo, Eun-Kyung;Park, Sung-Hoon;Kim, Cheol-Hong;Lee, Chang-Youl;Hwang, Yong-Il;Jang, Seung-Hun;Shin, Tae-Rim;Park, Sang-Myeon;Kim, Dong-Gyu;Lee, Myung-Goo;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.6
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    • pp.426-433
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    • 2010
  • Background: Persistent cough has recently been found to be associated with Chlamydia pneumoniae infection. We aimed to investigate the infection rate of C. pneumonia in adult patients with chronic cough. Methods: We recruited 68 patients with persistent cough lasting in excess of 3 weeks, who visited Kangdong Sacred Heart Hospital from January 2005 to August 2005. On the first visit, chest and paranasal sinuses radiography, skin prick test of common allergens, and induced sputum samples for C. pneumoniae were performed in all of patients. Further evaluation for diagnosis included a methacholine provocation test and eosinophil counts in induced sputum. Results: The most common cause of chronic cough was upper airway cough syndrome (UACS) (26.5%), followed by eosinophilic bronchitis (20.6%) and cough variant asthma (16.2%). Idiopathic chronic cough was the cause in 33.8% of patients. The mean duration of cough was 11.7 months. C. pneumoniae was isolated by polymerase chain reaction (PCR) from one patient who had upper respiratory air way syndrome. Conclusion: Chlamydia pneumoniae appears to have a minor role as a cause of chronic cough in patients.

Assessment of Systemic Arterial Thromboembolism with Multi-Slice Spiral CT in a Dog (개에서 다중나선형 CT촬영에 의한 동맥혈전색전증의 평가)

  • Shin, Seung-Ho;Lee, Ki-Chang
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.208-213
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    • 2007
  • A 15 kg 6-year-old intact male Jindo dog with a history of a respiratory distress, hindlimb paralysis with necrosed skin of dorsal digit for three weeks was referred to Animal Medical Center, Chonbuk National University. Heartworm infection was identified by kit examination. In plain thoracic radiographs, dilated pulmonary arteries reverse D sign and focal interstitial pattern was compatible with heartworm infection and possible pulmonary thromboembolism. Abdominal radiographs showed poor serosal detail indicating fluid accumulation within peritoneal cavity. No evidence of musculoskeletal abnormalities was found. Ultrasonography presented focal wedge-shaped hyperechogenecity on the both poles of left kidney, weak or absent pulse on the distal to the external iliac artery as well as ascites and irregular liver margin. Multi-organ failure was strongly supposed by blood profile including leukocytosis, anemia, hemoglobinuria bililubinemia, hypoalbuminemia, imbalance of electrolytes, and increased hepatic and renal function values. Interestingly, the glucose level is remarkably lower in pelvic limb compared to thoracic limb. Suspected pulmonary thromboembolism, renal infarction and femoral arterial embolization causing hindlimb paralysis and dermatic necrosis were confirmed by 3D reconstructed CT imaging. Prior to taking a consideration of euthanasia, interventional radiology was experimentally attempted but failed due to not recovered from general anesthesia. Early and accurate diagnosis of thromboembolism is valuable and 3D reconstructed CT images might be very useful to show the correct way to treat effectively.

A Study on the summer mortality of Korean rockfish Sebastes schlegeli in Korea (하절기 조피볼락, Sebastes schlegeli의 대량폐사에 관한 고찰)

  • Choi, Hye-Sung;Myoung, Jeong-In;Park, Myoung-Ae;Cho, Mi-Young
    • Journal of fish pathology
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    • v.22 no.2
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    • pp.155-162
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    • 2009
  • The mass mortality of Korean rockfish, Sebastes schlegeli that occured at the fish farms in Tongyeong and Geoje City regions between late August and early September in 2006 was investigated. Sixty two fish showed no significant external symptoms except ulcerative lesions with reddish foci on the skin. From the internal observations and diagnosis results, some yellowish brown liver, intestine bleeding, atrophy and congestion in the abdominal cavity of the fish were found. In the gill, swelled filaments caused by foreign material accumulation and mucus secretion were observed. However, the main cause of the fish mass mortality in both sampling regions could be due to physiological weakness induced by significant change of water temperature causing by typhoon Wookong during the summer in 2006.

A Study on the Major Symptoms by Each Pattern of Acne Vulgaris (여드름의 변증 유형별 주요 증후에 관한 연구)

  • Jeong, Woo-Yeol;Hong, Eu-Gene;Shin, Jun-Hyuk;Kim, Yoon-Bum;Nam, Hae-Jung;Kim, Kyu-Seok;Lee, Jun-Hee
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.27 no.4
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    • pp.76-86
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    • 2014
  • Objective : This study was performed to find out the differential points of the pattern identification for Acne vulgaris and suggest them to the clinic setting Methods : We searched the papers that suggest patterns identification for Acne vulgaris through China National Knowledge Infrastructure(CNKI), Oriental Medicine Advanced Searching Integrated System(OASIS), Korean Traditional Knowledge Portal(KTKP), Korean Studies Information Service System(KISS). We looked through all the papers, excluded unintended papers, and finally chose some papers that are suitable for inclusion. Then, We extracted all the patterns of Acne vulgaris and chose frequently suggested patterns. Finally we extracted symptoms from selected patterns and arranged them in order of frequency. Results and Conclusions : 1. We found 215 papers and chose 17 papers (Korean : 6, Chinese : 11). 2. We extracted total 67 demonstrations and chose Patterns of Wind-Heat, Damp-Heat, Phlegm and Static blood, Disharmony of the Thoroughfare and Controlling vessels. 3. In Acne vulgaris, the pattern of Wind-Heat tends to have a red papule, sometimes pustule, pain with itching, burning sensation, tidal reddening of the cheeks, white head or black head. The pattern of Damp-Heat tends to have a pustule, node, redness and swelling, pain and greasy skin. The pattern of Phlegm and Static blood has a tendency to be a nodule or cystoma that is hard, dark, painful, long lasting and hard to recover and easy to recur with a scar, pimple, pigmentation. The pattern of Disharmony of the Thoroughfare and Controlling vessels tends to be exacerbated before menstruation, have a small papule that is not easily treated under the chin or around the mouth.

Incidence Trends of Dermatophytoses Isolated in Children (소아에서 분리된 피부진균증의 발생경향)

  • Kim, Su Jung;Bang, Yong Joon
    • Korean Journal of Clinical Laboratory Science
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    • v.50 no.4
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    • pp.444-448
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    • 2018
  • From January 2 to December 30, 2017, out of 691 children diagnosed with dermatophytoses infection, 179 children had infections caused by Trichophyton among the total 13,093 patients who visited the Dermatology department. According to a survey, the patients included 317 adolescents, 203 elementary school age children, and 171 infants. In seasonal variation, the diagnosis was higher in summer (195 cases, 28%) and winter (191, 28%) and comparatively lower in spring (165, 24%) and autumn (140, 20%). The infection among the patients was caused by, from maximum to minimum, T. pedis (351, 51%), T. corporis (91, 13%), and T. unguinum (77, 11%). In all age groups, the highest number of patients were infected with T. pedis. After T. pedis, in descending order, the infection was caused by T. corporis, T. unguinum, T. manus and Tinea capitis in the infants and elementary school age children and by T. corporis, T. unguinum and T. cruris in adolescents. Among infections caused by Trichophyton, T. rubrum was the highest isolated causative agent. This data analysis confirmed the distribution of dermatophytoses and the different species according to paediatric age and will aid the study of paediatric dermatomycosis through continuous research.

Contact Investigation for Twins With Congenital Tuberculosis in the Neonatal Intensive Care Unit

  • Myung Hwan Yoo;Kyoung Sim Kim;Yong Wook Kim;Eun Young Kim;Young Kim;Hae In Jang;Hyoung Min Cho
    • Pediatric Infection and Vaccine
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    • v.29 no.3
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    • pp.141-146
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    • 2022
  • Purpose: Congenital tuberculosis (TB) is difficult to diagnose owing to its non-specific symptoms. Delayed diagnosis increases the risk of nosocomial infections. We examined the TB status of infants and healthcare workers who were in proximity to preterm twins diagnosed with congenital TB 63 days after birth and 48 days after admission to the neonatal intensive care unit (NICU). Methods: Contact investigations were conducted on 24 staff members and 35 infants who had contact with the twins with congenital TB. Results: Two of the exposed infants, both of whom had received the Bacille Calmette-Guérin vaccine, had positive tuberculin skin test results. Four of the 24 exposed staff members had positive interferon-gamma release assay (IGRA) test results before exposure and were not re-tested after exposure; the remaining 20 had negative IGRA test results. All exposed staff members and infants had normal chest radiographic findings. Conclusions: Although transmission of TB in the NICU is unusual, it can occur. These results support the need for a systematic investigation of the TB status of exposed infants, their family members, and healthcare workers.

Human Immunodeficiency Virus-Associated Gastrointestinal Kaposi's Sarcoma: A Case Report (후천성 면역 결핍 바이러스와 연관된 위장관 카포시 육종: 증례 보고)

  • Hee Joong Lim;So Hyun Park;Seung Joon Choi;Suyoung Park;Hee Young Lee;Jun Won Chung;Dong Hae Chung
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1260-1265
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    • 2020
  • Kaposi's sarcoma (KS) is a multicentric human immunodeficiency virus-associated neoplasm characterized by multiple vascular nodules in the skin, mucous membranes, and viscera. Gastrointestinal acquired immunodeficiency syndrome (AIDS)-related KS is the most common visceral involvement reported in disseminated disease. Here, we present the findings of a rare case of KS involving multiple organs with abdominal pain and active bleeding in the colon. Multiple intraluminal lesions were found in the terminal ileum, sigmoid colon, and rectum by ileocolonoscopy, and in the jejunum and ileum by fluoroscopy. Abdominopelvic CT revealed multiple enhanced flat lesions in the ileum and enlarged lymph nodes. The diagnosis was confirmed by histopathology, and antiretroviral therapy was initiated as the treatment of choice for KS. Owing to the increasing number of AIDS patients, it is essential for radiologists and clinicians to be aware of the imaging characteristics of KS to protect physicians from indiscriminate exposure to AIDS.

A Study on the Medical Accident Attack Rate in a Korean rural Area through the Sam Wha Medicare Insurance Union (충남 서산군 삼화의료보험조합을 통해본 일부 농촌지역 주민의 의료사고 발생율 및 진료수혜 실태 조사)

  • Ahn, Moon-Young;Lee, Jung-Ja;Nam, Taik-Sung
    • Journal of agricultural medicine and community health
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    • v.6 no.1
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    • pp.33-41
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    • 1981
  • To investigate the status of medical accident attack rate and medicare utilization during last 27months from 1st Oct., 1977 to 31st Dec. 1979 in the area under Sam Wha Medicare Insurance Union, the study was carried out through analyzing the medicare records of patients who were enrolled. "The medical accident" in this study was used as the meaning of the state that the people who have been treated morbid condition with insurance money. For the study, 2 doctors and one nurse were mobilized and the results are as follows: 1) The total number of the Medicare Insurance Union members among the 37,044 total population of the study area, (Hea-mi, Unsan, Eumam Myun) were 57, 35 composed of 3,000 males (52.3%) and 27, 35 females (47.7%) in 1977, 3,383 composed of 2,006 males (59.3%) 1,377 females (40.7%) in 1978, 2,573 composed of 1,437 males and 1,336 females (44.2%) in 1979. 2) Total number of medical accident attack cases were 6,774 case (partially overlapped the number of the 1977 with that of the 1978) and average annual medical accident attack rate per 1,000 population was 700.9. 3) Five major disease group in the past three years were disease of the respiratory system (177.7), disease of the digestive system (165.8), disease of the skin and subcutaneous(64.9), symptoms, signs and ill-defined conditions (64.6), any injury and poisoning (51.9). Mental disorders (32.6) was the 6th order disease group. 4) The order of the medical accident attack rate of age group per 1,000 population per year was the year group of 0~4(877.8), 45~64(832.6), 25~44(810.3), 5~14(495.1) 15~24(494.7) 65 and over (460.7). 5) Medical accident attack rate of age group per 1,000 population in the 5 major disease groups were the year group of 45~64 (100.0) in the mental disorders 0~4(525.1) in the disease of the respiratory system 45~64 (328.5) in the disease of the digestive system 0~4 (202.8) in the disease of the skin and subcutanous tissue, 25~44 (98.3) in the accidents and poisoning. 6) Monthly medical accidents attack rate were 87.0 in the winter (Dsc., Jan., Feb.) and 86.2 in the summer (Jun., July, Aug.). So the trend of the medical accidents attack rate during the year was bimount figure. 7) Monthly medical accidents attack rate in the major disease group were highest in Jan., Apr., (31.1) in the disease of the respiratory system, in Jan., Feb., Mar. (24.9) in the disease of the digestive system, in Jan., Jun., Aug. (9.8) in the injury and poisoning. 8) Duration of the treatment of the 93.1% of the total cases were within 5 days. 9) 299 cases (4.5%) of the total number of cases, 6,587 cases were referred to secondary and tertiary medicare facilities. 10) The order of the major 10 kinds of diagnosis of the disease, 6,587 cases during 27 months, were URI and chillness (1,063 cases, 16.1%), gastritis(830 cases, 12. 6%) dermatitis(360 cases, 5.5%), bronchitis(291 cases, 4.4%), neurosis (284 cases, 4.3%), contusion (165 cases, 2.5%), tooth extraction (157 cases, 2.4%), tonsillitis (109 cases, 0.7%), laceration (107 cases, 1.6%), neuralgia (105 cases, 1.6%), arthritis (104 cases, 1.6%), otitis media and mastoiditis (103 cases, 1.6%), so total case were 3,678 cases (55.9%).

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Usefulness of Tuberculin Test in Adult Patients with Suspected Pulmonary Tuberculosis (폐결핵이 의심되는 성인 환자에서 투베르쿨린 검사의 유용성)

  • Kang, Eun Hae;Koh, Won-Jung;Kwon, O Jung;Kim, Kyung Chan;Lee, Byoung-Hoon;Hwang, Jung Hye;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Lee, Kyung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.3
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    • pp.268-279
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    • 2004
  • Background : The tuberculin skin test has been used to diagnose latent tuberculosis infection, but is not widely used to diagnose or exclude pulmonary tuberculosis. The objective of this study was to evaluate the diagnostic utility of the tuberculin test in diagnosing and excluding pulmonary tuberculosis, and differentiating pulmonary tuberculosis from nontuberculous mycobacteria (NTM) pulmonary disease, when a sputum acid-fast bacilli (AFB) smear was positive. Material and Methods : From October 2002 to August 2003, among all the inpatients of the Division of Pulmonary and Critical Care Medicine at Samsung Medical Center, 258 patients with clinical suspicion of pulmonary tuberculosis were enrolled and underwent a tuberculin test. Results : 156 males and 102 females were included, with a mean age of 57.5 years. The final diagnoses included lung cancer in 89 cases (34.5%), pulmonary tuberculosis in 59 cases (22.9%), bacterial pneumonia in 33 cases (12.8%) and NTM pulmonary disease in 24 cases (9.3%). The positive tuberculin test rate was higher in the tuberculosis than non-tuberculosis group; 81.4 (48/59) vs. 42.4% (81/199). (p<0.001). In 208 patients with a negative sputum AFB smear, the result of the tuberculin test was positive in 69.4% (25/36) of the tuberculosis group and in 44.8% (77/172) of the non-tuberculosis group (p=0.007), so a positive result of the tuberculin test could predict pulmonary tuberculosis with 69.4% sensitivity, 55.2% specificity, a 24.5% positive predictive value and a 89.6% negative predictive value. In 50 patients with a positive sputum AFB smear, the positive rates of the tuberculin test were 83.9% (26/31) in tuberculosis group and 21.1% (4/19) in NTM pulmonary disease group (p<0.001), so a positive result of the tuberculin skin test could predict pulmonary tuberculosis with 83.9% sensitivity, 78.9% specificity, a 86.7% positive predictive value and a 75.0% negative predictive value. Conclusion : The tuberculin test could be useful in excluding pulmonary tuberculosis when the sputum AFB smear is negative, and to differentiate pulmonary tuberculosis from NTM pulmonary disease when the sputum AFB smear is positive.