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말기신부전 환자에서 Candida famata에 의해 발생한 심내막염

A Case of Infective Endocarditis in an End-Stage Renal Disease Patient Caused by Candida famata

  • 김정관 (예수병원 신장내과) ;
  • 황현철 (현대중앙병원 신장내과) ;
  • 장지연 (가톨릭대학교 의과대학 내과학교실) ;
  • 하성은 (가톨릭대학교 의과대학 내과학교실) ;
  • 김동휘 (가톨릭대학교 의과대학 내과학교실) ;
  • 최범순 (가톨릭대학교 의과대학 내과학교실)
  • Kim, Jeong Gwan (Division of Nephrology, Department of Internal Medicine, Presbyterian Medical Center) ;
  • Whang, Hyun Chul (Division of Nephrology, Department of Internal Medicine, Hyundae Jungang General Hospital) ;
  • Jang, Ji Yeon (Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea Seoul Saint Mary's Hospital) ;
  • Ha, Seong Eun (Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea Seoul Saint Mary's Hospital) ;
  • Kim, Dong Hwi (Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea Seoul Saint Mary's Hospital) ;
  • Choi, Bum Soon (Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea Seoul Saint Mary's Hospital)
  • 투고 : 2013.05.08
  • 심사 : 2013.05.31
  • 발행 : 2014.03.01

초록

혈액투석 중인 만성 신부전 환자에서 발생하는 진균성 심내막염은 일반적 감염성 심내막염보다 발생빈도는 적으나 예후는 좋지 않다. 그렇기 때문에 의심되는 소견을 보이면 경흉부 심장초음파와 함께 경식도 심장초음파의 적극적인 검사로 빠른 진단과 치료가 필요하다.

Infective endocarditis is rare in end-stage renal disease (ESRD) patients, who have a poorer prognosis than the general population. Candida endocarditis is rare and has a poor prognosis among causes of infective endocarditis. A 45-year-old male was admitted with sepsis combined with a hematoma on his right back. Candida famata was cultured in his blood. We treated him with antifungal agents. Echocardiography was performed to identify vegetations and diagnose endocarditis. In this case, surgical therapy was impossible because the patient's condition had deteriorated. We also administered antibiotics because methicillin-resistant Staphylococcus aureus was cultured from his sputum and a perianal abscess. The symptoms did not improve despite the ongoing treatment. Metabolic acidosis, hypotension, and a decreased state of consciousness developed and he died. We report a rare case of Candida endocarditis in an ESRD patient on hemodialysis.

키워드

참고문헌

  1. Moreillon P, Que YA. Infective endocarditis. Lancet 2004;363:139-149. https://doi.org/10.1016/S0140-6736(03)15266-X
  2. McCarthy JT, Steckelberg JM. Infective endocarditis in patients receiving long-term hemodialysis. Mayo Clin Proc 2000;75:1008-1014. https://doi.org/10.4065/75.10.1008
  3. Hoen B, Alla F, Selton-Suty C, et al. Changing profile of infective endocarditis: results of a 1-year survey in France. JAMA 2002;288:75-81. https://doi.org/10.1001/jama.288.1.75
  4. Filizcan U, Cetemen S, Enc Y, Cakmak M, Goksel O, Eren E. Candida albicans endocarditis and a review of fungal endocarditis: case report. Heart Surg Forum 2004;7:E312-314. https://doi.org/10.1532/HSF98.20041046
  5. Fowler VG Jr, Li J, Corey GR, et al. Role of echocardiography in evaluation of patients with Staphylococcus aureus bacteremia: experience in 103 patients. J Am Coll Cardiol 1997;30:1072-1078. https://doi.org/10.1016/S0735-1097(97)00250-7
  6. Nucifora G, Badano LP, Viale P, et al. Infective endocarditis in chronic haemodialysis patients: an increasing clinical challenge. Eur Heart J 2007;28:2307-2312. https://doi.org/10.1093/eurheartj/ehm278
  7. Rekik S, Trabelsi I, Hentati M, et al. Infective endocarditis in hemodialysis patients: clinical features, echocardiographic data and outcome: a 10-year descriptive analysis. Clin Exp Nephrol 2009;13:350-354. https://doi.org/10.1007/s10157-009-0172-8
  8. Nam HS, Song JK, Kim JJ, et al. A case of prosthetic valve endocarditis by candida parapsilosis. Korean J Med 1987;32:832-836.
  9. Hoen B. Infective endocarditis: a frequent disease in dialysis patients. Nephrol Dial Transplant 2004;19:1360-1362. https://doi.org/10.1093/ndt/gfh149
  10. Beyda ND, Chuang SH, Alam MJ, et al. Treatment of Candida famata bloodstream infections: case series and review of the literature. J Antimicrob Chemother 2013;68:438-443. https://doi.org/10.1093/jac/dks388

피인용 문헌

  1. Three Cases of Candidiasis Misidentified as Candida famata by the Vitek 2 System vol.35, pp.1, 2014, https://doi.org/10.3343/alm.2015.35.1.175