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A Case of Mycobacterium Massiliense Infection Presenting as Recurrent Pneumonia in Sjogren's Syndrome

쇼그렌 증후군 환자에서 발생한 Mycobacterium Massiliense에 의한 재발성 폐렴 1예

  • Seo, Ji-Young (Department of Internal Medicine, Wallace Memorial Baptist Hospital) ;
  • Lee, Byung-Hee (Department of Internal Medicine, Wallace Memorial Baptist Hospital) ;
  • Lee, Jang-Won (Department of Internal Medicine, Wallace Memorial Baptist Hospital) ;
  • Lee, Myeong-Hee (Department of Internal Medicine, Wallace Memorial Baptist Hospital) ;
  • O, Suk-Gyeong (Department of Internal Medicine, Wallace Memorial Baptist Hospital) ;
  • Cho, Hyun-Myung (Department of Internal Medicine, Wallace Memorial Baptist Hospital) ;
  • Lee, Chung-Won (Department of Internal Medicine, Wallace Memorial Baptist Hospital)
  • 서지영 (왈레스 기념 침례병원 내과) ;
  • 이병희 (왈레스 기념 침례병원 내과) ;
  • 이장원 (왈레스 기념 침례병원 내과) ;
  • 이명희 (왈레스 기념 침례병원 내과) ;
  • 오숙경 (왈레스 기념 침례병원 내과) ;
  • 조현명 (왈레스 기념 침례병원 내과) ;
  • 이충원 (왈레스 기념 침례병원 내과)
  • Published : 2012.08.01

Abstract

Mycobacterium massiliense is an emerging pathogen that is increasingly reported as a causative agent occurring during medical procedures, at surgical sites, and intramuscularly [1]. Although previously classified as part of M. abscessus, M. massiliense has recently been identified as a new species of rapidly growing nontuberculous mycobacteria [1,3] via a comparative sequence analysis of rpoB and hsp65 [3,5]. However, the clinical manifestations of M. massiliense have not been well characterized. We report here in a case of recurrent pneumonia for 3 years that improved with antibiotic treatment for M. massiliense in a 37-year-old woman with Sjogren's syndrome. The patient showed a substantial response to treatment with a combination of antimicrobial therapies comprising clarithromycin and amikacin without cefoxitin for 6 months. This is the first report of pulmonary infection of M. massiliense with Sjogren's syndrome in Korea.

최근 NTM에 대한 인식이 높아지면서 NTM의 분리율 및 NTM에 의한 질환이 증가하고 있다[1,4,7]. M. massiliense는 PCR-RFLP이라는 새로운 진단법으로 최근에 M. abscessus에서 분리되어 새롭게 분류된 균으로[1,4,5] 감염 경로 및 임상양상, 치료 지침에 대해서는 정확히 알려진 바가 없다. 국내에는 지금까지 임상 치료와 관련하여 총 2예의 증례 보고가 있었으나[6,8] 항생제 치료만으로 호전된 폐렴에 대한 보고는 없었다. 저자들은 일차성 쇼그렌 증후군을 진단받은 37세 여자 환자가 3년간 재발성 폐렴이 반복되던 중 M. massiliense가 동정된 후 적절한 항생제 치료만으로 호전된 예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

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