• Title/Summary/Keyword: Tuberculous abscess

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Pulmonary Mcosis (폐진균증)

  • 임병화;홍완일;김의윤
    • Journal of Chest Surgery
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    • v.6 no.1
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    • pp.29-36
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    • 1973
  • It has been known that the pulmonary mycosis generally results from saphrophytic colonization of pre-existing lung cavities, e.g. , due to pulmonary tuberculosis, abscess, bronchiectasis. or congen-ital cysts. Recently, the authors experienced four cases of the pulmonary mycosis which were all treated surgically, and in our opinion, three of them were considered to arise from secondary saphrophytic colonization of pre-existing tuberculous cavities by serial chest roentgenograms. One of them was actinomycosis which was known as relatively rare pulmonary mycosis, and its clinical experience was previously reported. The purpose of this report is mainly to review our clinical experience and some related literatures with three patients with aspergillosis. Many writers have stressed the sputum culture for aspergillus, immunologic study and serial roentgenographic findings were all important or essential in diagnosing aspergillosis. Surgical resection appears to be the treatment of choice for the mycosis of lung, and systemic administration of effective anti-fungal agents such as amphotericin B for aspergillosis and penicillin for actinomycosis respectively following surgical intervention is usually necessary to eradicate completely.

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The Clinical Study on the Characteristics of Pulmonary Lesions Which Should Be Differentiated from Pulmonary Tuberculosis in Lung Resection Cases (폐절제 예에서 결핵과 구별해야 할 질환의 특성에 관한 임상적 고찰)

  • 정황규;정성운;박서완
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1232-1240
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    • 1996
  • From January 1990 through June 1995, we operated on 121 patients who were suspected for pulmonary tuberculosis without definite final diagnosis. After operation the final pathologic diagnoses were as follows: 68 pulmonary tuberculosis in which 29 were tuberculoma, 23 lung cancer, 16 bronchiectasis, 6 aspergilloma, 2 lung abscess, 2 benign cyst and 4 others. In 121 cases, 81 were male and 40 were female and the peak age incidence was 4th decade in tuberculosis (39.7%) and 6th and 7th decade in lung cancer (69.6%). The diagnoses in 44 cases presented roentgenographically as pulmonary nodules were pulmonary tuberculosis(29 cases) and lung cancer(15 cases). Tuberculous nodules tended to be smaller in size with calcification and satellite lesions compared to carcinomas. Indications for operation were solitary nodules 44 cases (36.4%); destroyed lobe 31(25.6%); hemoptysis 25 (20.7%); cavitary lesion 11(9.1 %); bronchostenosis 3 (2.5%); destroyed lung 5(4.1 %) and destroyed lung with empyema 2(1.7%). We conclude that preoperatively suspected pulmonary tuberculosis should be distinguished from various pulmonary lesions such as carcinoma, bronchiectasis, aspergilloma, lung abscess and benign cyst. For the possibility of carcinoma, pulmonary nodules of size greater than 3cm, non-calcified, non satellite lesion, newly developed nodule even under the anti-tuberculous medication, negative PPD skin test with elevated CEA level are recommended for an early resectional surgery and follow-up and delayed surgery is recommended in cases such as pulmonary nodules less than 3 cm in size with calcification, satellite lesion, positive PPD skin reaction and elevated ESR, CRP, ALP levels.

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High Grade Sarcoma Arising from the Chest Wall of a Chronic Tuberculous Empyema - A case report - (만성 결핵성 농흉과 동반된 흉벽 악성 육종 - 1예 보고 -)

  • Chung, Won-Jae;Lee, Sung-Ho;Kim, Kwang-Taik;Kang, Moon-Chul;Chung, Jae-Ho;Son, Ho-Sung;Son, Kuk-Hui;Sun, Kyung
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.795-798
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    • 2008
  • A 50 year old male patient was admitted due to fever and left upper-quadrant abdominal pain. He had a history of previous treatment for pulmonary TB and splenectomy due to plastic anemia. A large peritoneal abscess with connection to a chronic left side tuberculous empyema thoracis was diagnosed on admission. Chest CT also revealed a soft issue lesion on the left anterior chest wall. Staged drainage of the peritoneal lesion followed by left side pleuropneumonectomy with chest wall resection was performed. The pathologic studies showed a high grade sarcoma of the chest wall.

A Case of Carotid Artery Pseudoaneurysm Misdiagnosed as Aggravation of Non-tuberculous Mycobacterial Lymphadenitis (비정형 결핵성 림프절염의 악화로 오인된 경동맥 가성동맥류 1예)

  • Noh, Woong Jae;Lee, Hyoung Shin;Kim, Sung won;Lee, Kang Dae
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.1
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    • pp.73-77
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    • 2017
  • An 81 year-old male patient presented with rapid enlargement of left lateral neck mass, diagnosed two months earlier as cervical nontuberculous mycobacterial lymphadenitis. Abscess formation and impending rupture related to aggravation of nontuberculous mycobacterial lymphadenitis was highly suspected. Unexpectedly, blood flow was detected by Doppler ultrasonography, which indicated possible vascular mass. Computed tomography demonstrated a $6.0cm{\times}4.0cm$ sized enhancing mass consistent with pseudoaneurysm of internal carotid artery. The patient underwent pseudoaneurysmectomy. Surgical drainage without adequate evaluation might have led to potentially life-threatening condition. We describe this rare case with importance of imaging screening in a neck mass.

A Clinical Study of Cavitary Lesions on Nondependent Region (비의존성(Nondependent) 위치의 공동성 병변에 관한 임상적 연구)

  • Moon, Soo-Nam;Kim, Do-Jin;Kim, Ki-Up;Lee, Sang-Moo;Kim, Hyeon-Tae;Uh, Soo-Taek;Kim, Yong-Hoon;Park, Choon-Sik;Chung, Yeon-Tae
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.4
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    • pp.410-415
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    • 1993
  • Background: The lung abscess predominantly occurs on a dependent region, because its major predisposing factor is aspiration. However, a lung abscess appeared on a nondependent region occasionally. Traditionally bronchoscopy has been performed in patients with lung abscess on a nondependent region for evaluating the endobronchial obstruction such as bronchogenic carcinoma. But the clinical characteristics and necessities of bronchoscopy in patients with lung abscess located at nondependent region have not been discussed previously. Thus, we investigated the underlying etiologies and the necessities of bronchoscpy in patients with lung abscess in a nondependent region. Method: Fifteen patients with cavitary lesion on a nondependent location have been studied retrospectively by reviewing their clinical records, chest PAs, computerized tomograms, and bronchoscopic findings. Results: 1) Most patients were older than 30 years except one, and their mean age was 51 years. The ratio of male to female was 6.5:1. 2) The underlying etiologies were bacterial infections in 13 cases, and tuberculous infection in two cases. However, bronchogenic carcinoma was not found as its etiology. 3) Among thirteen bacterial lung abcess, tweleve cases located at right middle lobe. 4) The findings of bronchoscopy were non-speicifc mucosal change in 8 cases and segmental obstructions in 2 cases. There were no malignant evidences in the finings of cytology and bronchscopic biopsy. 5) Among thirteen bacterial lung abcess, eleven patients showed good clinical reponse to antibiotic therapy. Conclusion: The necessity of early bronchoscopy may need to be re-evaluated in the lung abscess on a nondependent region, unless evidences of bronchial obstruction or bronchogenic carcinoma exist. The pulmonary tuberculosis shoud be regarded as the underlying etiology of the nondependent lung abscess.

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Nontuberculous Mycobacterial Infection after Body Contouring Procedure, Case Report (체형 교정 시술 후 발생한 비정형 마이코박테리아 감염, 증례 보고)

  • Jeong, Jae-Yeon;Lim, So-Young;Pyon, Jai-Kyong;Mun, Goo-Hyun;Bang, Sa-Ik;Oh, Kap-Sung
    • Archives of Plastic Surgery
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    • v.37 no.3
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    • pp.293-296
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    • 2010
  • Purpose: NTM (non tuberculous mycobacteria) is rare cause of surgical site infection after plastic surgery in immunocompetent patients. There are some reports about NTM infection after body contouring procedure from Latin America. But, there is no report in Korea. The purpose of this article is to report 2 patients with soft tissue infection caused by NTM after body contouring procedure. Methods: Two young female patients exhibited signs of inflammation and abscess after body contouring procedure. One patient underwent liposuction. The other underwent HPL (hypotonic pharmacologic lipo-dissolution) injection. Results: The result of tissue cultures were positive for NTM. All patients responded to the combined therapeutic approach. Conclusion: The goal of this article is to raise awareness among plastic surgeons who may encounter such patients in their practice. NTM should be included in the differential diagnosis of surgical site infection after body contouring surgery.

Surgical correction of adult tetralogy : Results of repair in 123 patients (성인 활로 4징증에 대한 개심술)

  • An, Hyuk;Suh, Kyung-Phill;Lee, Yung-Woo
    • Journal of Chest Surgery
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    • v.19 no.4
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    • pp.627-632
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    • 1986
  • This report describes our 17-years experience with intracardiac repair in 123 patients older than 15 years with tetralogy of Fallot. Major clinical manifestation was cyanosis and clubbing [102 Pts], but other minor associated manifestation were infective endocarditis, pulmonary tuberculosis, brain abscess, congestive heart failure, nephrotic syndrome, and tuberculous spondylitis. Prior palliative shunts had been performed in 10 patients. Preoperative hemoglobin ranged from 9.7 gm/dl to 25 gm/dl [mean 19 gm/dl]. The type of ventricular septal defect were typical perimembranous type, and total canal defect [13%]. The right ventricular outflow tract obstruction was due to combined [58.5%], infundibular [35%], and valvular stenosis [6.5%]. Transannular patch was used in 17% of patients. Hospital mortality was 9.8% in overall, but decreased to 1.7% since 1982. There was two late death [12 year actuarial survival [97%] due to fulminant hepatitis, residual abnormalities [PS, VSD]. Ninety two percent of survivors at follow-up are asymptomatic and leading an active normal life. Residual ventricular septal defect was detected with radionuclide single pass study in 15.3% of patients but almost cases were Qp/Qs less than 1.5, and only two patients had been candidates for reoperation.

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Lateral Neck Cyst as the Initial Presentation of Papillary Thyroid Carcinoma (측경부 낭종으로 발현된 유두상 갑상선암)

  • Park Cheong-Soo;Lee Won-Hung;Kim Choon-Kyu
    • Korean Journal of Head & Neck Oncology
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    • v.4 no.1
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    • pp.53-58
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    • 1988
  • We have experienced 3 cases of papillary carcinoma of the thyroid gland seen as lateral neck cyst, Usually cystic lesions of the neck have been considered as benign lesions from clinical viewpoint. The usual differential diagnosis includes branchial cleft cyst, cystic hygroma, dermoid cyst, cold abscess(tuberculous lymphadenitis) and cavitating squamous cell carcinoma. A lateral neck cyst as the sole presenting complaint of the papillary thyroid carcinoma is very rare. Preoperative diagnosis of lateral neck cyst is often diagnostic dilemma. Fine-needle aspiration cytology can be helpful in detecting the cancer cells and in demonstrating the nature of the fluid component of the lateral neck cyst. Presence of brown murky fluid from the aspirated fluid is highly suggestive of thyroid carcinoma. The thyroid scans and B-mode ultrasonography mayor may not be helpful to detect the primary focus of the thyroid gland. We suggest that a patient with a lateral neck cyst in adult age group should be considered to be a possibility of underlying thyroid carcinoma presanting as lateral neck cyst.

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A Case of Tuberculosis Presented with Pseudoaneurysm of the Aorta and Acute Respiratory Distress Syndrome (복부 대동맥 가성동맥류와 급성호흡곤란증후군으로 동시에 발현한 결핵)

  • Lee, Eung-Jun;Cho, Han-Su;Yoon, Hyun-Sung;Lee, Jung-Hyun;Lee, Tae Hoon;Yoo, Kwang Ha;Lee, Kye Young;Kim, Sun Jong
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.4
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    • pp.298-302
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    • 2008
  • We experienced a case of tuberculosis presented simultaneously with pseudoaneurysm of the aorta and ARDS. A 63-year-old man was admitted with complaints of fever and right upper quadrant abdominal pain for a week. Chest X-ray on admission showed a normal finding. Sub-diaphragmatic abscess on abdomen CT scan was suspected and serosanguinous fluid was aspirated from the abscess pocket. On day 2, he was getting more dyspneic and chest X-ray revealed extensive bilateral infiltration. Aspirated fluid revealed AFB. Later, follow-up abdomen CT scan revealed a leakage of dye from the aneurysmal sac of the descending aorta which was previously diagnosed as sub-diaphragmatic abscess. An aortic stent was placed, covering the opening into the aneurysm. The sputum also showed positive AFB. The patient was successfully weaned from the ventilator, and discharged with anti-tuberculous medication on day 42. Follow-up abdomen CT scan 6 months later showed that the aneurymal sac was completely disappeared.

A literatual studies on the Ong-Jeo in the special consideration of etiology and pathologic mechanism (癰疽에 대한 文獻的 考察;(病因.病機를 중심으로))

  • Roh, Hyun-Chan;Roh, Seok-Seon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.13 no.2
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    • pp.20-50
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    • 2000
  • This paper was written into condsideration records about the definition of "Ong-Jeo", the difference between "Ong" and "Jeo", the Western medical approach to "Ong-Jeo", and the etiology and pathologic mechanism of "Ong-Jeo". After this study, I report the following results from it. 1. "Ong" is an acute diapyesis disease which is found is in our skin and muscle and flesh. The chrateristics of this disease is that the affacted site is shine, no head, and the size is 3-4 chon. The prossess of the diesease shows that it is very quick, and very easily swell, and becomes pus easily, easily become to ulcer, easily converge. But this don't damage to the muscle and bone. 2. "Jeo" is the disease which damages bone-skeleton, muscle and flesh, and even destroy the stationary tissue. Jeo can be divided into two. One is called "Yudujeo" and it is acute diapydesis disease. The characteriscs of this disease is the miliary abscess, swell, has fever, and has an ache which is feeled spaned. And this is diffused into periphrey tissue and is diffused into deep site. After the ulcer, this becomes to shape the cellula. The size is more than 3-4 chon and this disease goes into chuk if this is serious. The other one is called "Mudujeo" and this disease is the ulcerative one in our joint and skeleton. The characteristic of this disease shows that the color of skin be not changed, and swell diffusely, and is not easily vanished, not easily becomes ulcerative, and not easily becomes converged. 3. "Ong-Jeo" is caused by the bacteriunm named by the "Golden and Yeollw Staphylococcus" in the Western medicine. "Ong" can be applicable to the carbuncle, acute diapyesis lymphadenitis, and some of cellulitis. "Jeo" can belong to cellulitis, and Mudujeo can belong to suppurative arthritis, suppurative osteomyelitis, tuberculous arthritis and osteomyelitis, and tuberculous lymphadenitis. 4. The etiologies of "Ong-Jeo" can be divided three, which are internal, external and other etiology which can not be clasiffied by two etiologies above. The internal etiology is seven emotion, and the external etiology is the six eumsa, unki, chunhang and so on. Other etiology is inadequate absorption of food, and excessive bang-sa. 5. The etiology of "Ong" is suppurative one which is choked between our skin and muscle and flesh, and is congested, become to hot, and finally erodes the muscle and flesh because of the inbalance of cirrculation in the enegy and blood. "Jeo" is the same as the Ong, but this is the suppurative disease which damages the muscle, flesh, and skeleton, and even damages into five Zang, the internal intestine.

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