• Title/Summary/Keyword: 결핵병

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A case of newly developed pulmonary lesion during the antitubercular agents in tuberculous pleurisy : A paradoxical response (결핵흉막염 치료중에 새로이 발생한 폐병변 1예 : 역설적 반응)

  • Park, Jee Min;Shin, Youn Ho;Chon, Gyu Rak;Shin, Hyun Joon;Choi, Young Chil
    • Clinical and Experimental Pediatrics
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    • v.52 no.6
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    • pp.717-720
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    • 2009
  • Paradoxical response refers to the enlargement of old lesions or unexpected appearance of new lesions after initial improvement following treatment with antitubercular agents. Various types of paradoxical responses have been reported in the world, but they are rarely reported in Korean children. We report the case of a 17-year-old boy who was diagnosed with tuberculous pleurisy and was treated appropriately. Although the tuberculous pleurisy initially responded to medication with resolution of the pleural fluid, a new pulmonary lesion subsequently developed 3 weeks after the initiation of treatment that eventually cleared with continuation of the original drug regimen.

10 Cases of Paradoxical Expansion of Intracranial Terculomas During Chemotherapy (역설적 두개강내 결핵종 10예)

  • Minn, Yang-Ki
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.3
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    • pp.260-264
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    • 2001
  • Background : Paradoxical intracranial tuberculoma is tuberculoma that developed or was enlarged during antituberculous therapy. The course of the disease or effective treatment are not well known. Method : Patients who developed intracranial tuberculoma or an enlarged tuberculoma during antituberculous therapy were investigated. Ten patients were enrolled. Result : Paradoxical intracranial tuberculoma was detected 67.9 days after antituberculous therapy. The symptoms worsened over a period of 102.3 days. Improvement was noted after 165.4 days. Four patients recovered on the brain image and 4 recovered clinically. The CSF findings showed that the paradoxical tuberculomas had developed or were aggravated, the CSF findings was aggravated. Conclusion : Paradoxical intracranial tuberculoma can develop without specific symptoms. Paradoxical intracranial tuberculoma may not be a paradoxical response and may be a natural course of intracranial tuberculosis or a natural response to antituberculous therapy.

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Drug Resistance Rate of New Pulmonary Tuberculosis Patients Treated from the Private Sector in 2003~2005 (2003~2005년도 민간 병의원 신환자에서 분리된 결핵균의 항결핵약제 내성률)

  • Park, Young Kil;Park, Yoon Sung;Bai, Jeong Ym;Kim, Hee Jin;Lew, Woo Jin;Chang, Chul Hun;Lee, Hee Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.2
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    • pp.87-94
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    • 2008
  • Background: Surveillance of TB drug resistance (DR) is essential for providing information on the magnitude and trends in resistance, for developing treatment guidelines and for monitoring the effect of interventions. Up to now national surveys of drug resistance of M. tuberculosis have been conducted four times since 1994 among patients registered at health centers. The purpose of this study is to estimate the prevalence of primary drug resistance among new cases identified in private sector, and to compare it with the previous national drug resistance surveys. Methods: The study collected results of drug susceptibility testing (DST) performed at the Korean Institute of Tuberculosis by the request of private sector from January 2003 to December 2005, and then finally selected new cases for the analysis from the database of Korean TB Surveillance (KTBS) by matching patients' name and social identification numbers. Results: Of the 5,132 new patients included in the study, 689 (13.4%) patients were found to have drug resistance at least one drug, 530 patients (10.3%) were isoniazid resistant, 195 patients (3.8%) were multi-drug resistant (MDR), and 21 patients (0.4%) were extensively drug resistant (XDR). The rate of drug resistance tended to decrease annually but it was not statistically significant. When compared with previous national DR surveys in 2003 and in 2004 respectively, they were not significantly different. Conclusion: The prevalence of DR among new cases managed in the private sector did not show significant difference from that of new patients registered in the public sector in the same year.

Detection of Specific Antibody to Mycobacterium tuberculosis in Anti-Complementary Human, Rabbit and Bovine Serum by Supplementation with Procomplementary Porcine Serum (친보체성(親補體性) 돼지혈청의 보강(補强)에 의한 항보체성(抗補體性) 사람, 토끼 및 소혈청속의 인결핵균(人結核菌)(Mycobacterium tuberculosis)에 대한 특이항체검출(特異抗體檢出))

  • Choi, Chul-Soon;Yang, Yong-Tae
    • The Journal of the Korean Society for Microbiology
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    • v.16 no.1
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    • pp.39-48
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    • 1981
  • A direct complement fixation test supplemented with procomplementary porcine serum was studied using anticomplementary human, rabbit and bovine serum against Mycobacterium tuberculosis. Procomplementary activity of porcine serum varied with porcine individual and affected by anticomplementary antiserum. The procomplementary titre of porcine serum against rabbit, human and bovine serum ranged from 1:5 to 1:40. By means of complement fixation test supplemented by porcine serum, the specific complement-fixing antibody to both tuberculopolysaccharide and/or tuberculoprotein antigen was readily differentiated from the anticomplementary antibody titre.

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Clinical Evaluation of Surgical Resection of Pulmonary Tuberculosis (폐결핵에 대한 외과적 치험)

  • Park, Seung-Kyu;Shon, Mal-Hyun;Han, Dong-Gi;Ha, Hyun-Chul;Jin, Young-Ho;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.4
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    • pp.474-480
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    • 1995
  • Background: In spite of initial intensive and long-term chemotherapy for pulmonary tuberculosis, many problems remain in the treatment of the residual lesion. The role of surgical intervention for pulmonary tuberculosis is getting rid of such residual lesion of pulmonary tuberculosis to support the healing process and to induce bacteriologically negative conversion in the end. Method: We experienced 30 cases of pulmonary resection for pulmonary tuberculosis from Aug. 1994 through Apr. 1995 in National Masan Tuberculosis Hospital. We conducted retrospective study to analyze several variables for the cases. Results: 1) The ratio between male and female was 4:1(male 24, female 6) and the age of peak incidence was in 3rd and 4th decades. 2) Indications for pulmonary resection in the radiographic findings were cavitary lesions of 19 cases(63.3%), destroyed one side of 8 cases(26.7%) and destroyed one lobe of 3 cases(10%). 3) 16 of 20 cases with unilateral lesions and all of 10 cases with bilateral lesions on chest X-ray films showed AFB positive on preoperative sputum smears. 14 cases(87.5%) of unilateral lesions and 9 cases(90%) of bilateral ones were converted into AFB negative postoperatively. Negative conversion rates of pneumonectomy and lobectomy cases were 100% and 85.7%, respectively. 4) Preoperative combined disease was 3 cases(10%) of DM and postoperative complications were 2 cases(6.7%) of dead space and no death. Conclusion: Chemotherapy only has some limitation in treatment of all tuberculosis. So, surgical intervention for pulmonary tuberculosis is an effective method as partner of chemotherapy.

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Pulmonary Resection Combined with Isoniazid-and Rifampin-based Drug Therapy for Patients with Multidrug-resistant Tuberculosis (다제내성 폐결핵 환자에서 폐절제술 후 일차 항결핵제 치료)

  • Park, Seung-Kyu;Kim, Jin-Hee;Kim, Jun-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.2
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    • pp.179-185
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    • 2005
  • Background : To evaluate the clinical efficacy of pulmonary resection combined with first-line antituberculous drug therapy in patients with well-localized, cavities-containing pulmonary multidrug-resistant tuberculosis (MDR-TB). Method : From February 1998, seventeen patients with well-localized, cavities-containing pulmonary MDR-TB were enrolled and followed prospectively up to December 2004. After radical pulmonary resection, the patients were treated with antituberculous drugs comprising of isoniazid (H), rifampin (R), pyrazinamide (Z), ethambutol (E), and streptomycin (S) (3HERZS/3HERS/6HER). Results : All recovered isolates of M. tuberculosis were resistant to both isoniazid and rifampin, and to a mean of 4.8 antituberculous drugs (range, 2 to 7 drugs). Surgical procedures included lobectomy (13 patients), lobectomy plus segmentectomy (3 patients), and pneumonectomy (1 patient). The median time for postoperative sputum smear and culture conversion was 2 days (range, 1 to 23 days). Fifteen (94%) patients had durable cures (mean follow-up period, 39.0 months). One patient failed to convert her sputum and was successfully switched to second-line therapy; one patient developed active disease again almost 7 years later, likely due to re-infection with a new M. tuberculosis strain. Conclusion : Radical resection combined with administration of first-line antituberculous agents was effective in patients with well-localized, cavities-containing pulmonary MDR-TB.