Burkholderia pseudomallei에 의한 전립선 농양 1예

A Case of Prostatic Abscess due to Burkholderia pseudomallei

  • 홍영미 (왈레스 기념 침례병원 내과) ;
  • 김병석 (왈레스 기념 침례병원 내과) ;
  • 박성민 (왈레스 기념 침례병원 내과) ;
  • 박일우 (왈레스 기념 침례병원 내과) ;
  • 박주철 (왈레스 기념 침례병원 내과) ;
  • 이병희 (왈레스 기념 침례병원 내과) ;
  • 조현명 (왈레스 기념 침례병원 내과)
  • Hong, Young-Mi (Department of Internal Medicine, Wallace Memorial Baptist Hospital) ;
  • Kim, Byung-Seok (Department of Internal Medicine, Wallace Memorial Baptist Hospital) ;
  • Park, Seong-Min (Department of Internal Medicine, Wallace Memorial Baptist Hospital) ;
  • Park, Il-Woo (Department of Internal Medicine, Wallace Memorial Baptist Hospital) ;
  • Park, Ju-Chul (Department of Internal Medicine, Wallace Memorial Baptist Hospital) ;
  • Lee, Byung-Hee (Department of Internal Medicine, Wallace Memorial Baptist Hospital) ;
  • Cho, Hyun-Myung (Department of Internal Medicine, Wallace Memorial Baptist Hospital)
  • 발행 : 2011.10.01

초록

Melioidosis는 열대지방의 토양과 지표수에 광범위하게 존재하는 호기성 그람음성 간균인 Burkholderia pseudomallei에 의한 감염질환으로 동남아시아와 북 호주 지역에서 주로 발병하는 열대 풍토병이다. 흡입과 접종이 주요 감염경로이며 감염의 선행요인인 당뇨병, 신장 질환, 간경화, 지중해 빈혈증, 알코올 중독, 질병이나 약물로 인한 면역 저하자 등에서 발병하는 것으로 알려져 있다. 폐렴, 간/비장 농양, 요로 감염, 피부/연부조직 감염, 신경계 감염, 복강 내 감염, 골/관절 감염, 심/혈관 감염 등의 다양한 형태로 발병하고 폐렴이 가장 흔하게 발생한다. 국소적인 농양은 흔히 아급성, 만성적으로 발병하며 수개월에서 수년 후에 발병할 수도 있다. 간, 비장을 비롯한 다양한 장기를 침범할 수 있으나 전립선 농양은 흔하지 않다. 국내에는 지금까지 총 4예의 증례 보고가 있었으며, 이는 폐렴 및 균혈증, 패혈성 쇼크로 발병한 증례였으며 국내에서는 아직 요로생식기계 감염은 보고된 적은 없다. 저자들은 말레이시아에 근무한 적이 있는 48세 남자 당뇨병 환자에서 Burkholderia pseudomallei에 의한 전립선 농양 및 이에 합병된 고환 농양을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Melioidosis is an infectious disease caused by the Gram-negative bacillus, Burkholderia pseudomallei. It is endemic in Southeast Asia and northern Australia, where B. pseudomallei is a soil saprophyte and invades the host through inoculation, inhalation or ingestion. It infects mostly adults with predisposing conditions, mainly diabetes mellitus. The lung is the most commonly affected organ, presenting with either cough or fever resulting from a primary spread. Also, seeding and abscess formation can arise in any organ. However, prostatic abscess due to melioidosis is uncommon. We report a case of pneumonia, and prostate and scrotal abscesses due to Burkholderia pseudomallei, in a 48-year-old man with diabetes mellitus who had a history of working in Malaysia. This is the first report of genitourinary infection of melioidosis in Korea.

키워드

참고문헌

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