The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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A Case of Continuous Ambulatory Peritoneal Dialysis-Associated Peritonitis Caused by Mycobacterium abscessus

Mycobacterium abscessus에 의해 발생한 지속적 외래 복막투석 관련 복막염 1예

  • Ann, Hea Won (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Cho, Yong In (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Han, Sang Hoon (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Choi, Jun Yong (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Song, Young Goo (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Choi, Kyu Hun (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, June Myung (Department of Internal Medicine, Yonsei University College of Medicine)
  • 안혜원 (연세대학교 의과대학 내과학교실) ;
  • 조용인 (연세대학교 의과대학 내과학교실) ;
  • 한상훈 (연세대학교 의과대학 내과학교실) ;
  • 최준용 (연세대학교 의과대학 내과학교실) ;
  • 송영구 (연세대학교 의과대학 내과학교실) ;
  • 최규헌 (연세대학교 의과대학 내과학교실) ;
  • 김준명 (연세대학교 의과대학 내과학교실)
  • Received : 2012.11.19
  • Accepted : 2013.10.11
  • Published : 2014.07.01
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Abstract

Mycobacterium abscessus has been reported to cause opportunistic infections in immunocompromised patients. It is a very rare pathogen in continuous ambulatory peritoneal dialysis (CAPD)-associated peritonitis. However, we experienced a single case of peritonitis caused by M. abscessus in a patient on CAPD in South Korea. A 52-year-old female on CAPD for 9 years with a past history of recurrent CAPD-associated peritonitis presented with fever, abdominal pain and turbid peritoneal dialysate. CAPD-associated peritonitis did not improve with broad-spectrum antibiotic treatment, and pathogens were not detected in a routine peritoneal fluid bacterial culture. M. abscessus was isolated from a peritoneal fluid mycobacterial culture. The patient recovered after treatment with clarithromycin and levofloxacin for 24 months.

M. abscessus는 자연환경에 널리 분포되어 있으며 면역 저하 환자에게 심각한 감염증을 일으킬 수 있는 병원균이다. 국내에서는 M. abscessus에 의해 발생한 복막투석 관련 복막염이 보고되어 있지 않지만 세균 배양에서 병원균이 동정되지 않거나 경험적 항생제 치료에 호전되지 않는 복막투석 관련 복막염 환자에서 고려해야 할 감염 원인 균주 중의 하나이다. 저자들은 지속적 외래 복막투석을 시행하는 환자에서 M. abscessus에 의해 발생한 복막염을 경험하여 문헌고찰과 함께 보고하는 바이다.

Keywords

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