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A Case of Acute Pyelonephritis Caused by Enterococcus Hirae in a Patient with a Horseshoe Kidney

마제신 환자에서 발생한 Enterococcus hirae 신우신염 1예

  • Kim, Ki Hyun (Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Yoon, Ji Hyun (Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Tae Hoon (Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Yoon, Hong Jin (Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Cheon, Jae Young (Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Jin, Sung Joon (Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Song, Young Goo (Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine)
  • 김기현 (연세대학교 의과대학 강남세브란스병원 내과) ;
  • 윤지현 (연세대학교 의과대학 강남세브란스병원 내과) ;
  • 김태훈 (연세대학교 의과대학 강남세브란스병원 내과) ;
  • 윤홍진 (연세대학교 의과대학 강남세브란스병원 내과) ;
  • 천재영 (연세대학교 의과대학 강남세브란스병원 내과) ;
  • 진성준 (연세대학교 의과대학 강남세브란스병원 내과) ;
  • 송영구 (연세대학교 의과대학 강남세브란스병원 내과)
  • Received : 2013.07.18
  • Accepted : 2013.11.04
  • Published : 2014.09.01

Abstract

Enterococcus hirae mainly causes infections in animals. It has been rarely encountered in humans and, in most such cases, it is considered to be a contaminant or resident flora. Since the first case of septicemia by E. hirae was reported in 1998, only two cases of acute pyelonephritis (APN) have been reported in Korea. We describe herein a case of APN caused by E. hirae in an 83-year-old man with a horseshoe kidney. Although E. hirae was isolated only from urine and not from the blood, we were able to diagnose it as the causative organism based on the patient's clinical findings, imaging study results, and risk factors including old age, benign prostatic hypertrophy, and a horseshoe kidney.

동물에서 감염증을 일으키는 것으로 알려진 E. hirae는 사람의 임상 검체에서 드물게 분리되고 발견되더라도 대부분 오염균이나 상재균으로 생각되었기 때문에 E. hirae에 의한 요로감염의 보고는 매우 드물다. 하지만 본 증례에서와 같이 요로감염의 위험 요인이 많은 환자에서는 혈액배양에서 균이 동정되지 않고 소변배양 검사에서만 E. hirae가 동정되었다고 하더라도 임상양상을 통해 요로감염의 원인균으로 볼 수 있겠다. 따라서 향후 임상 검체에서 E. hirae가 동정되었을 때 임상양상을 바탕으로 원인균인지 여부를 평가하고 E. hirae 감염증의 임상적 특징, 항균제 감수성 등에 대한 자료를 축적해 나가는 것이 중요하겠다.

Keywords

References

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