면역기능이 정상인 환자에서의 폐 효모균증 1례

A Case of Pulmonary Cryptococcosis in an Immunocompetent Patient

  • 노은숙 (가톨릭대학교 의과대학 여의도 성모병원 내과학교실) ;
  • 박민경 (가톨릭대학교 의과대학 여의도 성모병원 내과학교실) ;
  • 안지원 (가톨릭대학교 의과대학 여의도 성모병원 내과학교실) ;
  • 이승재 (가톨릭대학교 의과대학 여의도 성모병원 내과학교실) ;
  • 손혜숙 (가톨릭대학교 의과대학 여의도 성모병원 내과학교실) ;
  • 성혜영 (가톨릭대학교 의과대학 여의도 성모병원 내과학교실) ;
  • 최선욱 (가톨릭대학교 의과대학 여의도 성모병원 내과학교실) ;
  • 김길선 (가톨릭대학교 의과대학 여의도 성모병원 내과학교실) ;
  • 형복진 (가톨릭대학교 의과대학 여의도 성모병원 내과학교실) ;
  • 이상훈 (가톨릭대학교 의과대학 여의도 성모병원 내과학교실) ;
  • 김용현 (가톨릭대학교 의과대학 여의도 성모병원 내과학교실) ;
  • 송정섭 (가톨릭대학교 의과대학 여의도 성모병원 내과학교실)
  • Roh, Eun Suk (Department of Internal Medicine, St. Mary's Hospital, The Catholic University of Korea, College of medicine) ;
  • Park, Min Kyung (Department of Internal Medicine, St. Mary's Hospital, The Catholic University of Korea, College of medicine) ;
  • An, Ji Won (Department of Internal Medicine, St. Mary's Hospital, The Catholic University of Korea, College of medicine) ;
  • Lee, Seung Jae (Department of Internal Medicine, St. Mary's Hospital, The Catholic University of Korea, College of medicine) ;
  • Son, Hye Suk (Department of Internal Medicine, St. Mary's Hospital, The Catholic University of Korea, College of medicine) ;
  • Sung, Hye Young (Department of Internal Medicine, St. Mary's Hospital, The Catholic University of Korea, College of medicine) ;
  • Choi, Son Ook (Department of Internal Medicine, St. Mary's Hospital, The Catholic University of Korea, College of medicine) ;
  • Kim, Guil Sun (Department of Internal Medicine, St. Mary's Hospital, The Catholic University of Korea, College of medicine) ;
  • Hyoung, Bok Jin (Department of Internal Medicine, St. Mary's Hospital, The Catholic University of Korea, College of medicine) ;
  • Lee, Sang Hun (Department of Internal Medicine, St. Mary's Hospital, The Catholic University of Korea, College of medicine) ;
  • Kim, Yong Hyun (Department of Internal Medicine, St. Mary's Hospital, The Catholic University of Korea, College of medicine) ;
  • Song, Jeong Sup (Department of Internal Medicine, St. Mary's Hospital, The Catholic University of Korea, College of medicine)
  • 투고 : 2005.08.22
  • 심사 : 2005.09.21
  • 발행 : 2005.12.30

초록

저자들은 면역 기능의 장애가 없는 건강한 성인남자에게서 이전에 수 차례 보고 된 바 있는 단순한 고립성 폐결절, 경화, 종격동 종괴의 방사선학적 소견이 아닌 양쪽폐야의 다발성의 결절 및 공동화를 동반한 경화의 흔치 않은 방사선 소견을 보이는 폐 효모균증 1예를 문헌 고찰과 함께 보고하는 바이다.

We experienced a case of pulmonary cryptococcosis in an immunocompetent patient who presented with uncommon radiological findings. He complained of a dry cough for 3 weeks. The chest X-ray and CT showed multiple, variable sized, and irregular patch consolidations with cavities combined with some ground glass opacities in both lower lung fields. The diagnosis was made histologically via a thoracoscopic lung biopsy. The patient was administered oral fluconazole has since been well.

키워드

참고문헌

  1. Park CS, Ahn SY, Lee SH, Hong WK, Kim SK. A case report of cryptococcus restricted within mediastinum. Korean J Medicine 1986; 30:567-73
  2. Kang HC, Jang GL, Jung JY, Kim KS. A case of pulmonary cryptococcosis. Korean J Medicine 1988;36:139-46
  3. Park JC, Kim HT, Jeung H, Park JH, Choi JH, Kim HT et al. Various Pulmonary Manifestations of the cryptococcal pneumoniae in the three immunocompetent patients. Tuberculosis and Respiratory diseases 2001;50:359-66 https://doi.org/10.4046/trd.2001.50.3.359
  4. The Korean society for microbiology. Opportunistic fungal infection. Medical biology; 1991.p.694
  5. Mandell GL, Benett JE, Dolin R. Principle and practice of infectious disease. 4th ed. New york: Churchill livingstone, Inc.; 1995. p. 2331-40
  6. Lee MS, Woo JH. Pulmonary cryptococcosis. J of Infection 1998; 30:86-93
  7. Khoury MB, Godwin JD, Ravin CE, Gallis HA, Halvorsen RA. Thoracic cryptococcosis: Immunologic competence and radiologic appearance. Am J Roentgenol 1984;142:893-6 https://doi.org/10.2214/ajr.142.5.893
  8. Gordonson J, Birnbaum W, Jacobson G, Sargent EN. Pulmonary cryptococcosis. Radiology 1974;112:557-61 https://doi.org/10.1148/112.3.557
  9. Gal AA, Koss MN, Hawkins J, Evans S Einstein H. The pathology of pulmonary cryptococcal infection in the AIDS. Arch Pathol Lab Med 1986;110:502-8
  10. Sider L, Westcott MA. Pulmonary manifestations of cryptococcosis in patients with AIDS: CT features. J Thorac Imaging 1994;9:78-84 https://doi.org/10.1097/00005382-199421000-00004
  11. Lee CY, Kim H, Kim JS, Kim H, Woo SK. HRCT finding of pulmonary cryptococcosis in immune competent patients. J Korean Radiol Soc 2001;44:167-71 https://doi.org/10.3348/jkrs.2001.44.2.167
  12. McDonnell JM, Hutchins GM. Pulmonary cryptococcosis. Hum Pathol 1985;16:121-8 https://doi.org/10.1016/S0046-8177(85)80060-5
  13. Duperval R, Hermans PE, Brewer NS, Robert GD. Cryptococcosis with emphasis on the significance of isolation of Cryptococcus neoformans from the respiratory tract. Chest 1977;7:13-9
  14. Kerkering TM, Duma RJ, Ochi T, Osugi T, Kikui M, Takahashi H. Japanese summer-type hypersensitivity pneumonitis: Studies using Cryptococcus antigen. Clin Allergy 1982;12:343-54 https://doi.org/10.1111/j.1365-2222.1982.tb02538.x