• Clinical and Experimental Pediatrics
• /
• 제63권12호
• /
• pp.469-476
• /
• 2020

The major pathogens that cause atypical pneumonia are Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila. Community-acquired pneumonia (CAP) caused by M. pneumoniae or C. pneumoniae is common in children and presents as a relatively mild and self-limiting disease. CAP due to L. pneumophila is very rare in children and progresses rapidly, with fatal outcomes if not treated early. M. pneumoniae, C. pneumoniae, and L. pneumophila have no cell walls; therefore, they do not respond to β-lactam antibiotics. Accordingly, macrolides, tetracyclines, and fluoroquinolones are the treatments of choice for atypical pneumonia. Macrolides are the first-line antibiotics used in children because of their low minimum inhibitory concentrations and high safety. The incidence of pneumonia caused by macrolide-resistant M. pneumoniae that harbors point mutations has been increasing since 2000, particularly in Korea, Japan, and China. The marked increase in macrolide-resistant M. pneumoniae pneumonia (MRMP) is partly attributed to the excessive use of macrolides. MRMP does not always lead to clinical nonresponsiveness to macrolides. Furthermore, severe complicated MRMP responds to corticosteroids without requiring a change in antibiotic. This implies that the hyper-inflammatory status of the host can induce clinically refractory pneumonia regardless of mutation. Empirical macrolide therapy in children with mild to moderate CAP, particularly during periods without M. pneumoniae epidemics, may not provide additional benefits over β-lactam monotherapy and can increase the risk of MRMP.

• Korean Journal of Radiology
• /
• 제21권5호
• /
• pp.537-540
• /
• 2020

Recently, some global cases of 2019 novel coronavirus (COVID-19) pneumonia have been caused by second- or third-generation transmission of the viral infection, resulting in no traceable epidemiological history. Owing to the complications of COVID-19 pneumonia, the first symptom and imaging features of patients can be very atypical and early diagnosis of COVID-19 infections remains a challenge. It would aid radiologists and clinicians to be aware of the early atypical symptom and imaging features of the disease and contribute to the prevention of infected patients being missed.

• Korean Journal of Radiology
• /
• 제21권10호
• /
• pp.1161-1164
• /
• 2020

The epidemic of 2019 novel coronavirus, later named as coronavirus disease (COVID-19), began in Wuhan, China in December 2019 and has spread rapidly worldwide. Early diagnosis is crucial for the management of the patients with COVID-19, but the gold standard diagnostic test for this infection, the reverse transcriptase polymerase chain reaction, has a low sensitivity and an increased turnaround time. In this scenario, chest computed tomography (CT) could play a key role for an early diagnosis of COVID-19 pneumonia. Here, we have reported a confirmed case of COVID-19 with an atypical CT presentation showing a "double halo sign," which we believe represents the pathological spectrum of this viral pneumonia.

• 한국방사선학회논문지
• /
• 제5권6호
• /
• pp.391-400
• /
• 2011

폐렴은 호흡기계의 감염이고 원인균, 병인, 침범부위, 그 밖의 여러 가지 상황에 따라서 다양하게 분류된다. 비정형 병원균주 페렴으로 의심되어 내원한 46세의 남자 환자에서 이학학적 소견이나 혈액검사, 객담도말검사, 소변검사, 기생충검사, 기관지내시경검사, 침생검 등에서 특이할만한 원인균을 찾지 못했으며, 청진이상, 고열, 고혈압, 객담, 호흡곤란 등의 증상 또한 보이지 않았다. 세균성 또는 비정형 병원균의 광범위치료 항생제 복용이나 기생충제제를 복용하였으나 재발되었으며, 자연치유 및 재발이 반복되며 호전되었다. 반흔을 남기며 호전되고 새로운 부위에 결절이 재발하기를 반복하면서 서서히 없어지는 기간은 평균 20일 정도였다. 재발 이후 흉부엑스선 촬영과 흉부 고해상 전산화단층촬영을 추적 검사한 결과 흉부엑스선 촬영에서는 특이한 징후를 관찰하지 못했으나 고해상 전산화단층촬영에서는 병변이 호전되어가고 새로운 부위에 재발되는 모습을 관찰할 수가 있었다. 양측 하부 폐에 재발성 경과를 취한 비정형병원균주 폐렴이 의심되는 환자의 경우, 흉부엑스선 촬영 소견은 횡격막이나 간(Liver), 척추 등에 의해 숨기 때문에 추적검사로서 도움을 주는 데는 한계가 있으며, 흉부 고해상 전산화단층촬영 검사를 하여 비교하는 것이 바람직하다. 저자는 재발성 경과를 취한 비정형 병원균주 폐렴1예에 대한 문헌고찰과 함께 보고한다.

• Childhood Kidney Diseases
• /
• 제3권1호
• /
• pp.104-108
• /
• 1999

Atypical hemolytic uremic syndrome associated with neuraminidase-producing Streptococcus pneumoniae usually associated with invasive infection such as fulminant pneumonia, sepsis, and meningitis and may occur earlier in lift and has a higher mortality rate than typical hemolytic uremic syndrome. We have experienced a 22-month-old female patient with hemolytic uremic syndrome associated with S. pneumoniae pneumonia and empyema. The patient was treated with ceftriaxone and washed red blood cell transfusion. As the disese course could be aggravated by the use of blood products containing anti-Tomsen-Friedenreich antigen, early recognition and sensible use of blood products such as washed RBC might lead to the improved outcome.

• Korean Journal of Radiology
• /
• 제21권5호
• /
• pp.545-549
• /
• 2020

The 2019 novel coronavirus (2019-nCoV) outbreak in Wuhan, Hubei Province, China in 2019 led to large numbers of people being infected and developing atypical pneumonia (coronavirus disease 2019, COVID-19). Typical imaging manifestations of patients infected with 2019-nCoV has been reported, but we encountered an atypical radiological manifestation on baseline computed tomography (CT) images in three patients from Wuhan, China infected with the 2019-nCoV. Surprisingly, the only similar CT finding was a solitary sub-centimeter ground-glass nodule adjacent to bronchovascular bundles, which could be easily overlooked. In addition, the follow-up images in these patients showed how COVID-19 pneumonia evolved from these small nodules. The radiologic manifestation of the three cases will expand contemporary understanding of COVID-19.

• 대한한방내과학회지
• /
• 제22권3호
• /
• pp.489-494
• /
• 2001

Pneumonia is the disease caused by inflammation of lung parenchyma. Major symptoms of pneumonia are fever, cough, etc and consolidation is seen in chest x-ray. When pleurisy gets in complication of pneumonia, pleural effusion occurs. Also chest pain occurs by pleurisy. Gyulhyung is the disease of which major symptom is chest pain. Sugyulhyung from in Gyulhyung, the water sound is audible from the flank side the fact that as Sugyulhyung. Symptom of Gyulhyung is similar to that of pneumonia. We diagnosed this case as Gyulhyung and administrated Banhabogryeongtang to patient. As result, there is remarkable Improvement in symptom and chest x-ray.

• Tuberculosis and Respiratory Diseases
• /
• 제45권2호
• /
• pp.444-450
• /
• 1998

PCP remains the leading cause of deaths in patients with AIDS. As familiarity with PCP increases, atypical manifestations of the diseases are being recognized with greater frequency. There are following "atypical" manifestations of PCP ; 1) interstitial lung response that include diffuse alveolar damage, bronchiolitis obliterance, interstitial fibrosis, and lymphoplasmocytic infiltrate 2) striking localized process frequently exhibiting granulomatous features 3) extensive necrosis & cavitation 4) extrapulmonary dissemination of the disease. A wide variety of pathologic manifestations may occur in PCP in human immunodeficiency virus-infected patienst and that atypical features should be sought in lung biopsies from patients at risk for PCP. We had experienced a case of PCP, which presented with severe hypoxia, progressive dyspnea and fine crackles. It was diagnosed as PCP in AIDS with manifestation of BOOP by open lung biopsy and showed good response to Bactrim & corticosteroid therapy.

• Clinical and Experimental Pediatrics
• /
• 제52권3호
• /
• pp.277-282
• /
• 2009

Pneumonia, which usually requires hospitalization for children, is caused by various pathogens. According to recent surveys, the prevalence of atypical pneumonia caused by Mycoplasma or Chlamydia has increased, especially in preschool children. Also, the evidence has been accumulated that Mycoplasma or Chlamydia infection is associated with asthma including both inception and exacerbation. Therefore, it is important to consider how the clinical aspects of Mycoplasma pneumonia have changed. In particular, Chlamydia pneumonia, which has not been prevalent in Korea, needs greater attention.

• Tuberculosis and Respiratory Diseases
• /
• 제58권6호
• /
• pp.554-561
• /
• 2005

The clinical and radiographic findings of lung cancer have been well established many journals. Even if the radiographic findings of lung cancer show a typical pattern, the specific cell type of lung cancer sometimes needs to be determined prior to a pathological diagnosis. For example, the usual finding of a squamous cell carcinoma is similar to other cancer types such as an adenocarcinoma or a small cell carcinoma but with a lower incidence. Therefore, it should not be used to make a diagnosis of the cell type prior to a pathological diagnosis. Many unusual findings of lung cancer, so called atypical pattern have been reported, but atypical findings are widely accepted. The more important thing is not to diagnose a specific cell type of cancer but to differentiate it from other benign conditions such as tuberculosis, fungal infections or organizing pneumonia. This paper presents typical information of the cell type of lung cancer along with the atypical radiographic findings.