Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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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 (Department of Internal Medicine, Konkuk University Hospital, School of Medicine, Konkuk University) ;
  • Cho, Han-Su (Department of Internal Medicine, Konkuk University Hospital, School of Medicine, Konkuk University) ;
  • Yoon, Hyun-Sung (Department of Internal Medicine, Konkuk University Hospital, School of Medicine, Konkuk University) ;
  • Lee, Jung-Hyun (Department of Internal Medicine, Konkuk University Hospital, School of Medicine, Konkuk University) ;
  • Lee, Tae Hoon (Department of Internal Medicine, Konkuk University Hospital, School of Medicine, Konkuk University) ;
  • Yoo, Kwang Ha (Department of Internal Medicine, Konkuk University Hospital, School of Medicine, Konkuk University) ;
  • Lee, Kye Young (Department of Internal Medicine, Konkuk University Hospital, School of Medicine, Konkuk University) ;
  • Kim, Sun Jong (Department of Internal Medicine, Konkuk University Hospital, School of Medicine, Konkuk University)
  • 이응준 (건국대학교 의과대학 내과학교실) ;
  • 조한수 (건국대학교 의과대학 내과학교실) ;
  • 윤현성 (건국대학교 의과대학 내과학교실) ;
  • 이정현 (건국대학교 의과대학 내과학교실) ;
  • 이태훈 (건국대학교 의과대학 내과학교실) ;
  • 유광하 (건국대학교 의과대학 내과학교실) ;
  • 이계영 (건국대학교 의과대학 내과학교실) ;
  • 김순종 (건국대학교 의과대학 내과학교실)
  • Received : 2008.03.06
  • Accepted : 2008.04.10
  • Published : 2008.04.30
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Abstract

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.

결핵은 다양한 양상으로 나타나며 결핵성 대동맥 가성 동맥류는 아주 드문 질환으로 알려져 있고 급성호흡곤란 증후군 또한 드물지만 생명을 위협하는 결핵의 합병이다. 저자들은 결핵성 대동맥 가성동맥류와 급성호흡곤란증후군이 동시에 발현해서 항결핵화학요법과 혈관내 스텐트 삽입술로 성공적으로 치료한 환자를 경험하였다. 치명적인 결핵의 합병이 조기 진단과 빠른 항결핵제의 투여로 치료되었다고 생각된다. 따라서 결핵의 합병증을 치료하는 데 조기 진단이 중요하고 이를 위해 결핵에 대한 임상적인 의심을 높게 유지하는 것이 중요하다는 것을 보고하 참는 바이다.

Keywords

References

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