The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지

Disseminated Mycobacterium avium complex infection in a patient with AIDS and fever of unknown origin

불명열 에이즈 환자에서 발생한 파종성 조류형 결핵균 감염 1예

  • Heo, Hyun-Mi (Depantment of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Jun, Yoon-Hee (Depantment of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Kim, So-I (Depantment of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Lee, Myung-Won (Depantment of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Sung, Sun-Hee (Depantment of Pathology, Ewha Womans University School of Medicine) ;
  • Lee, Mi-Ae (Depantment of Laboratory Medicine, Ewha Womans University School of Medicine) ;
  • Choi, Hee-Jung (Depantment of Internal Medicine, Ewha Womans University School of Medicine)
  • 허현미 (이화여자대학교 의학전문대학원 내과학교실) ;
  • 전윤희 (이화여자대학교 의학전문대학원 내과학교실) ;
  • 김소이 (이화여자대학교 의학전문대학원 내과학교실) ;
  • 이명원 (이화여자대학교 의학전문대학원 내과학교실) ;
  • 성순희 (이화여자대학교 의학전문대학원 병리학교실) ;
  • 이미애 (이화여자대학교 의학전문대학원 진단검사의학교실) ;
  • 최희정 (이화여자대학교 의학전문대학원 내과학교실)
  • Received : 2009.08.14
  • Accepted : 2009.10.15
  • Published : 2010.08.01
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Abstract

Since the first AIDS case was reported in 1985, the number of patients with AIDS and infectious complications has been increasing in Korea. Mycobacterium avium complex (MAC) infection is a common opportunistic infection in patients with AIDS, especially those with lower CD4+T cell counts. Although MAC is a common systemic bacterialinfection in developed countries, few cases have been reported among AIDS patients in Korea. MAC infection is rare in an immunocompetent person, but is an important cause of morbidity and mortality in patients with AIDS. MAC infection is typically associated with the degree of immunosuppression, duration of HIV infection, and low CD4+T cell counts. Here we report a case of disseminated MAC infection in an AIDS patient with fever, mesenteric lymph node enlargement, and pancytopenia.

우리나라에서 에이즈환자의 기회감염증은 칸디다증, 결핵과 주폐포자충 폐렴이 가장 흔하며 그 중 결핵이 가장 위중한 기회감염이나, 최근에는 국내에서도 결핵 유병률의 감소와 더불어 비결핵 항산균 감염이 점차 증가하고 있다. 따라서 항산균 양성 환자에서 결핵과 비결핵 항산균의 감별이 중요하다. 최근에는 real-time PCR법이 개발되어 기존의 중합효소 연쇄 반응법보다 빠르고 결핵균과 비결핵 항산균을 함께 검출하여 감별할 수 있다. 저자들은 에이즈 환자에서 복강내 임파절 조직검사와 real-time PCR법을 통해 확진된 파종성 결핵균 감염 환자를 화학 요법으로 치료하였기에 이를 보고하는 바이다.

Keywords

References

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