• 제목/요약/키워드: tuberculosis patient

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Mycobacterium Avium-intracellulare Complex와 M. Fortuitum에 의한 폐항산균증(肺抗酸菌症) 3례(例) (Nontuberculous Pulmonary Infection in Two Patients with Mycobacterium avium-intracellulare Complex and a Patient with M. fortuitum)

  • 김상재;홍영표;배길한;김성진;진병원;정충모
    • 대한미생물학회지
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    • 제17권1호
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    • pp.87-93
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    • 1982
  • Two cases of pulmonary disease in a 54 year-old female and a 70 year-old male patient due to Mycobacterium avium-intracellulare complex(MAIC) and a case of pulmonary infection ina 69 year-old male patient due to M. fortuitum(MF) were found recently in this institute. All three patients had a long history of anti-tuberculous chemotherapy because they were initially diagnosed as pulmonary tuberculosis. A 70 year-old male patient infected with MAIC had an unsuccessful chemotherapy history of isoniazid(INH), para-aminosalicylic acid(PAS) and streptomycin(SM) with an incomplete, temporary, symptomatic improvement, for three years since 1964 when he was first diagnosed as pulmonary tuberculosis on physical examination. A 54 year-old female patient infected with MAIC also had an unsuccessful chemotherapy history with the various anti-tuberculous drugs since 1958. Both patients discharged large number of MAIC in their sputum specimens for at least more than one year, but no M. tuberculosis at all. A 69 year-old male patient infected with MF was diagnosed as moderately advanced pulmonary tuberculsis in 1977. Combined chemotherapy with INH+PAS+pyrazinamide(PZA) improved his clinical symptoms, however, his chest radiograph was deteriorated again in 1980 one year after he stopped therapy. Therefore he started chemotherapy again with INH+ethionamide(TH)+cycloserine(CS) but no improvement was noticed. MF was cultured from his sputum in August 1981 and he continuously discharged the same bacilli until last examination of January 1982. Whether all three patients were initially !infected with nontuberculous mycobacteria or complicated with predisposing tuberculosis was not clear because there were no reliable bacteriological examination records.

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Tuberculous Epididymo-Orchitis with Multifocal Extrapulmonary Tuberculosis: a Case Report

  • An, Jihae;Kim, Keum Won
    • Investigative Magnetic Resonance Imaging
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    • 제26권1호
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    • pp.71-75
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    • 2022
  • Tuberculous epididymo-orchitis, a rare form of extrapulmonary tuberculosis, results from hematogenous dissemination or retrograde extension from the lower urinary tract. Herein, we studied the case of a 22-year-old male patient who presented with refractory left scrotal pain and inflammation. The patient also complained of multifocal pain involving the right buttock, posterior thigh, and right wrist, without trauma history. The patient was diagnosed with multifocal tuberculosis by sputum AFB study and right sacroiliac joint biopsy.

원인불명의 고열 및 흉수 이후 악화된 폐결핵후유증 소양인환자 치험 1례 보고 (A Case Report of a Soyangin Patient with Aftereffects of the Tuberculosis Aggravated after a Pleural Effusion and a High Fever of Unknown Origin)

  • 이재욱;허한솔;조혜원;임은철
    • 사상체질의학회지
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    • 제28권2호
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    • pp.163-175
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    • 2016
  • Objectives It is important to care aftereffects of the tuberculosis such as cough and sputum especially for the old. The purpose of this study is to report a case which showed symptoms improvement after treatment with Hyungbangjihwang-tang.Methods To evaluate the results of this treatment, Decrease of cough and sputum was assessed by Visual Analogue Scale(VAS). The patient`s oral intake and body weight were measured.Results The patient who suffered with cough and sputum after tuberculosis developed high fever and pleural effusion of unknown origin. After treatment with western and oriental medicine, high fever and pleural effusion were subsided but cough and sputum got worse and body weight was decreased after high fever and pleural effusion. So we prescribed Hyungbangjihwang-tang and then the symptoms of the patient were improved.Conclusions This study suggests that using Sasang constitutuional medical treatment is effective for Soyangin patient with afftereffects of the tuberculosis such as cough and sputum.

The Rapid Drug Susceptibility Testing of Mycobacterium tuberculosis by GenoType$^{(R)}$ MTBDRplus in Contaminated Specimen

  • Heo, Reun;Kim, Yoon-Sik
    • 대한의생명과학회지
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    • 제19권4호
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    • pp.330-337
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    • 2013
  • There are several methods currently being used to diagnose tuberculosis in patients, such as smear, PCR, tuberculosis culture and X-ray. For a proper medical treatment, antimicrobial susceptibility test and rapid drug susceptibility testing have been operated. Tuberculosis bacilli usually need 3~8 weeks of culture period because of delay in RNA synthesis and require 15~22 hours for generation. After a germ raises in culture, we initiated antimicrobial susceptibility test for a proper treatment. It has some difficulties to give a proper prescription for a tuberculosis patient because antimicrobial susceptibility test requires 4 weeks. To supplement this, we are practicing drug susceptibility testing which allow us to know the sensibility of RMP and INH after 2 or 3 days. But this is only possible when more than 2 positive germ. Therefore, we should practice rapid drug susceptibility testing with culture test. But if media is contaminated by other germs except Mycobacterium tuberculosis, it's hard to interpret result about culture test and to practice antimicrobial susceptibility test and rapid drug susceptibility testing. Because we have to practice again smear, culture test after extracting specimen from the patient, time is consumed and proper patient treatment is postponed. To address these problems and quick patient treatment, rapid drug susceptibility testing is practiced by using GenoType$^{(R)}$ MTDRplus method. As a result of this method we detected sensibility 10 and 7 cases and resistance 0 and 3 cases using RIM and INH respectively with other 1 case toward medicals out of the total 11 test. In conclusion rapid drug susceptibility testing can be used from the contaminated specimen after elimination of contaminated source from culture and proved that it can be practiced for rapid examination of a tuberculosis patient.

Video프로그램을 통한 환자교육이 결핵환자 치료이행행위에 미치는 영향 (The Effect of Behavior Modification on Enhancing Patient Adherence to Tuberculosis Treatment Regimens)

  • 정은리
    • 대한간호학회지
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    • 제26권3호
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    • pp.697-708
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    • 1996
  • Most efforts to improve tuberculosis treatment adherence target the patient and his or her behavior. This study examined the effects of behavioral modification training for these patients. Based on Bandura's behavioral principles of modeling, intervention strategies using a video program were devised to elicit specific patient target behaviors considered to improve patients' adherence to tuberculosis treatment regimens. A random assignment, two-group(experimental group and control group) research design including 81 subjects was used. The main outcomes measured were pill taking measured with the Medication Event Monitoring System(MEMS) Medication Cap, patients' self-efficacy, and their knowledge of tuberculosis. The findings are as follows : 1) There was a significant difference between the experimental group and the control group in patients' feelings of self-efficacy. That is, the patients who received the behavior modification program showed greater feeling of self-efficacy to initiate and change their behavior for the tuberculosis treatment regimen than the patients who did not receive the program(t=3.51, p=0.01). 2) There was a significant difference between the experimental group and the control group in patients' knowledge of tuberculosis. That is, the patients who received the behavior modification program showed higher level of knowledge of tuberculosis than the patients who did not receive the program(t=2.15, p=0.03) 3) There was a significant difference between the experimental group and the control group in patients' adherence to tuberculosis treatment regimens. That is, the patients who received the behavior modification program showed greater adherence to the treatment regimens than the patients who did not receive the program(t=5.11, p=0.00). The study findings provided useful insights into nursing practice, particularly in planning intervention strategies aimed at enhancing patients' adherence in tuberculosis that may also be relevant to other chronic diseases with patient adherence problems.

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반복적인 결절조직 배출 후 호전된 기관지 결핵 1예 (A Case of Endobronchial Tuberculosis with Repeated Expectoration of Nodular Tissues)

  • 김수웅;이병훈;안영수;김남인;엄우연;우정주;김상훈
    • Tuberculosis and Respiratory Diseases
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    • 제59권2호
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    • pp.204-208
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    • 2005
  • 기관지 결핵은 치료 기간이 길고 후유증이 나타날 수 있어 적극적인 치료와 세심한 추적관찰을 요하는 질환이다. 저자들은 항결핵 화학요법 중 무기폐가 진행되었다가 특별한 시술 없이 물리치료와 체위배농만으로 결절 조직이 자연 배출된 후 임상 증상 및 방사선 소견이 호전된 기관지 결핵 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

역설적 반응에 의하여 동시에 결핵성 뇌농양 및 결핵성 복막염이 발생한 증례 1예 (A Case Report of Tuberculous Brain Abscess and Tuberculous Peritonitis Developing Due to Paradoxical Reactions)

  • 안태홍;박민범;이기조;정은호;김진우;서상렬;강석우;김은나;한윤주;조삼권
    • Tuberculosis and Respiratory Diseases
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    • 제66권6호
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    • pp.457-462
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    • 2009
  • 역설적 반응은 감수성 있는 항결핵제를 복용중인 결핵 환자에서 치료시작 당시의 병변이 악화되거나 새로운 병변이 생기는 현상이고 이는 치료실패와 감별을 요한다. 일반적으로 역설적 반응은 기존 항결핵 치료로 좋은 결과를 보이므로, 이러한 임상 경과를 잘 이해함으로써 불필요한 검사나 치료약제 변경 등을 하지 않고 적절히 치료할 수 있게 될 것이다. 저자들은 적절한 항결핵제 치료 중에도 역설적 반응으로 결핵성 뇌농양, 결핵성 복막염이 연속적으로 병발한 환자 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

다양한 특이결핵항원을 이용한 결핵항체 검사(ELISA)의 진단적 유용성 (Diagnostic Significance of the Serologic Test Using Multiple Antigens of Mycobacterium Tuberculosis by ELISA)

  • 김대연;최인환;박승규;조상래;송선대
    • Tuberculosis and Respiratory Diseases
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    • 제47권6호
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    • pp.757-767
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    • 1999
  • Background: Diagnosis by smear and/or cultures of the Mycobacterium tuberculosis from body fluid or biopsy specimen is "Gold standard". However the sensitivity of the direct microscopy is relatively low and culture of mycobacteria is time consuming. Despite an explosion in the techniques of rapid identification of mycobacteria by molecular genetic means, it is laborious and expensive and then rapid, inexpensive serodiagnosis is interested in diagnosis of tuberculosis. But sensitivity and specificity of known serologic antigen is not full sufficient level and then new antigen develop and combination cocktails of new developed antigens by ELISA are needed. Method: To compare the efficacy of different mycobacterial specific antigen and to assess the applicability of the combination of several different antigens in the diagnosis of tuberculosis, five ELISA tests derived 14KDa, 16KDa, 19KDa, 23KDa, 38KDa were evaluated in 57 active pulmonary patient and 24 inactive post-therapy follow up patient and 48 normal control. Results: The optical densities of ELISA test with 14KDa, 16KDa, 19KDa, 23KDa, 38KDa were significantly higher in active tuberculosis cases than in normal control(P<0.001, P<0.001, P<0.027, P<0.001, P<0.001) and those with 16KDa, 38KDa were significant higher in active tuberculosis cases than in inactive post-therapy follow up cases(P<0.01. P<0.001) and those of 14KDa, 16KDa, 23KDa, 38KDa were significant higher in inactive post-therapy follow up cases than in normal control(P<0.008. P<0.01. P<0.006. P<0.001). The sensitivity of 14KDa, 16KDa, 19KDa, 23KDa, 38KDa in active pulmonary patient cases was 42.1%, 43.9%, 15.8%, 28.0%, 70.2%, respectively and the specificity of 14KDa, 16KDa, 19KDa, 23KDa, 38KDa in active pulmonary patient cases was 95.8%, 95.8%, 91.7%, 89.6%, 93.8%, respectively. The sensitivity and specificity of combination 38KDa with 16KDa was 87% and 93.7%. Conclusion: The sensitivity and specificity of new antigens for serodiagnosis of the tuberculosis still remains limited at around 70%, which makes its a poor diagnostic tool for disease confirmation. A combination of cocktail antigens provided by cut-off value adjustment for serodiagnosis of tuberculosis some improved diagnostic yield than single antigen serologic test.

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폐결핵 환자에서 발생한 점액표피양 암종 1예 (A Case of Mucoepidermoid Carcinoma in Pulmonary Tuberculosis Patient)

  • 정재만;송주영;홍재락;김영준;김문식
    • Tuberculosis and Respiratory Diseases
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    • 제41권4호
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    • pp.429-434
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    • 1994
  • 저자들은 폐결핵 치료중 흉통, 발열, 기침 등 폐렴소견과 단순흉부 X 선상 결핵의 악화소견으로 본 병원에 입원한 67세 남자에서 순차적인 단순흉부X선과 기관지 내시경 및 조직생검을 통하여 좌측 주기관지에서 발생한 고등급의 점액표피양 암종을 확인하였으며, 진단후 17개월만에 사망한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

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