The Korean Journal of Medicine

  • 제81권5호
  • /
  • Pages.667-672
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  • 2011
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
권호 표지

눈돌림신경 장애가 합병된 쯔쯔가무시병 1예

A Case of Scrub Typhus Complicating Oculomotor Nerve Impairment

  • 윤나라 (조선대학교 의학전문대학원 내과학교실) ;
  • 이완수 (조선대학교 의학전문대학원 내과학교실) ;
  • 이준 (조선대학교 의학전문대학원 내과학교실) ;
  • 이희정 (조선대학교 의학전문대학원 내과학교실) ;
  • 권세훈 (조선대학교 의학전문대학원 내과학교실) ;
  • 추인성 (조선대학교 의학전문대학원 신경과학교실) ;
  • 김동민 (조선대학교 의학전문대학원 내과학교실)
  • Yun, Na-Ra (Department of Internal Medicine, Chosun University School of Medicine) ;
  • Lee, Wan-Soo (Department of Internal Medicine, Chosun University School of Medicine) ;
  • Lee, Jun (Department of Internal Medicine, Chosun University School of Medicine) ;
  • Lee, Hee-Jung (Department of Internal Medicine, Chosun University School of Medicine) ;
  • Kwon, Se-Hoon (Department of Internal Medicine, Chosun University School of Medicine) ;
  • Choo, In-Sung (Department of Neurology, Chosun University School of Medicine) ;
  • Kim, Dong-Min (Department of Internal Medicine, Chosun University School of Medicine)
  • 발행 : 2011.11.01
⟨ 이전 논문 다음 논문 ⟩

초록

쯔쯔가무시병은 다양한 임상증상을 보일 수 있고 예기치 못한 중증 합병증을 야기할 수 있는 질환으로 이에 대한 빠른 진단과 적절한 치료, 합병증 발생에 대한 적절한 대응이 필요하다. 저자들은 54세 여자에서 가역적 눈돌림신경 장애를 동반한 뇌수막염의 합병증이 발생한 쯔쯔가무시병을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi that manifests with fever, skin rash, and myalgia. The spectrum of clinical severity ranges from mild to severe, with fatal complications including acute renal failure, gastrointestinal bleeding, meningoencephalitis, myocarditis, and pneumonitis. We report here a case of a 54-year-old woman with scrub typhus complicating oculomotor nerve impairment.

키워드

참고문헌

  1. Elisberg BL, Campbell JM, Bozeman FM. Antigenic diversity of rickettsia tsutsugamushi: epidemiologic and ecologic significance. J Hyg Epidemiol Microbiol Immunol 1968;12:18-25.
  2. Kim DM. Clinical features and diagnosis of scrub typhus. Infect Chemother 2009;41:315-322. https://doi.org/10.3947/ic.2009.41.6.315
  3. Cracco C, Delafosse C, Baril L, et al. Multiple organ failure complicating probable scrub typhus. Clin Infect Dis 2000; 31:191-192. https://doi.org/10.1086/313906
  4. Kim SJ, Chung IK, Chung IS, et al. The clinical significance of upper gastrointestinal endoscopy in gastrointestinal vasculitis related to scrub typhus. Endoscopy 2000;32:950-955. https://doi.org/10.1055/s-2000-9621
  5. Kim DM, Kim HL, Park CY, et al. Clinical usefulness of eschar polymerase chain reaction for the diagnosis of scrub typhus: a prospective study. Clin Infect Dis 2006;43:1296-1300. https://doi.org/10.1086/508464
  6. Lee SH, Kim DM, Cho YS, Yoon SH, Shim SK. Usefulness of eschar PCR for diagnosis of scrub typhus. J Clin Microbiol 2006;44:1169-1171. https://doi.org/10.1128/JCM.44.3.1169-1171.2006
  7. Brazis PW, Masdeu JC, Biller J. Localization in Clinical Neurology. 5th ed. Philadelphia: Lippincott Williams & Wilkins, 2007.
  8. Lee BK, Park TH, Cho SC, Lee DY, Kim JS. 3 cases of tsutsugamushi disease with meningitis in children. Korean J Infect Dis 1993;25:183-187.
  9. Kim JS, Ku BJ, Na KR, et al. A case of scrub typhus complicated with acute renal failure, meningoencephalitis and hepatitis. Korean J Med 1997;53:436-439.
  10. Lyu S, Hwang EC, Kim IH, Hong SK, Pai H, Lee GH. A case of tsutsugamushi disease complicated by meningoencephalitis. Korean J Infect Dis1999;31:243-246.
  11. Pai H, Sohn S, Seong Y, Kee S, Chang WH, Choe KW. Central nervous system involvement in patients with scrub typhus. Clin Infect Dis 1997;24:436-440. https://doi.org/10.1093/clinids/24.3.436
  12. Silpapojakul K, Ukkachoke C, Krisanapan S, Silpapojakul K. Rickettsial meningitis and encephalitis. Arch Intern Med 1991; 151:1753-1757. https://doi.org/10.1001/archinte.1991.00400090051010
  13. Kang JI, Kim DM, Lee J. Acute sensorineural hearing loss and severe otalgia due to scrub typhus. BMC Infect Dis 2009;9:173. https://doi.org/10.1186/1471-2334-9-173
  14. Premaratna R, Chandrasena TG, Dassayake AS, Loftis AD, Dasch GA, de Silva HJ. Acute hearing lossdue to scrub typhus: a forgotten complication of a reemerging disease. Clin Infect Dis 2006;42:e6-e8. https://doi.org/10.1086/498747
  15. Kim DM, Weon YC, Hur SJ, et al. A case of scrub typhus with reversible hearing loss. Korean J Med 2009;77:793-796.
  16. Khullar SK, DiSario JA. Gastric outlet obstruction. Gastrointest Endosc Clin N Am 1996;6:585-603.
  17. Ellis H. Pyloric stenosis complicating duodenal ulceration. World J Surg 1987;11:315-318. https://doi.org/10.1007/BF01658108
  18. Haubrich WS. Bockus Gastroenterology. 5th ed. Philadelphia: WB Saunders Co, 1995.
  19. Im EH, Yang HW, Seo SW, et al. Long-term outcome of endoscopic balloon dilatation of benign pyloric stricture. Korean J Gastrointest Endosc 2000;21:838-843.
  20. Park JH, Shim SG. Upper gastrointestinal endoscopic features and predictable factors for clinical severity in the patients with tsutsugamushi disease. Korean J Med 2005;69:518-527.