• Korean Journal of Veterinary Research
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• v.47 no.4
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• pp.443-447
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• 2007

A 7-year-old, female snow goose (Anser caerulescens hyperboreus) with history of decreased activity for 2 month died in Daejeon Zoo Land in September 2006. At necropsy, granulomatous pneumonia and hepatomegaly with multiple cysts were observed. Small masses were found in the spleen. Microscopically, fibrinous pneumonia distributed in most of the lung lobe with pulmonary edema and congestion. Especially, granulomatous inflammation with numerous multinucleated giant cells was observed around the dilated bronchi. To confirm the diagnosis, acid-fast (Ziehl-Neelsen method) and periodic acid-Schiff (PAS) staining was performed. Acid-fast staining showed red bacterial colony indicating tuberculosis. PAS staining was also positive enough to diagnose aspergillus spp. co-infection that was an opportunistic fungi occurring in immuno-compromised animals. Based on the above results, we confirmed that the case submitted was diagnosed as avian tuberculosis.

• Korean Journal of Veterinary Service
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• v.38 no.3
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• pp.195-198
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• 2015

Mannheimia haemolytica is an opportunistic bacterium that is widely recognized among the bovine respiratory disease (BRD) complex in cattle. Five Hanwoo with a history of fever, anorexia and dyspnea were died within 2 days in a the middle of summer. Four cattle were pregnant. The cattle house were located in mountainous area but the window for air ventilation was open only one side. In addition, the fecal material for fermentation was located indoor. Air ceiling fan did not work. The indoor temperature was $40^{\circ}C$. After working on air fan, the indoor temperature was still $36^{\circ}C$. On necropsy, there was fibrinous pleuritis with a rich yellowish pleural fluids in the thorax. The cross-section of the lung showed lobar fibrinonecrotic pneumonia with expanded interlobular septa by edema and fibrin. Microscopically, parenchymal necrosis with dense layer of inflammatory cells were observed surrounding interlobular septum. Fibrin and inflammatory cells were filled in the alveoli. Bacteriological cultures of pulmonary tissue showed growth of M. haemolytica. This pneumonia case in Hanwoo suggests that environmental stressors such as high temperature, insufficient air ventilation, and pregnancy be the cause of mannheimoisis. Control of environmental stressor, such as temperature indoor is necessary to prevent BRD caused by M. haemolytica.

• Tuberculosis and Respiratory Diseases
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• v.69 no.6
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• pp.469-473
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• 2010

Nocardia farcinia, an aerobic, gram-positive bacilli actinomycetes of the genus Nocardia, is an uncommon pathogen found in humans. The most common Nocardia infection sites are the lung, central nervous system, and skin. Even though hematogenous dissemination can occur, isolation of the organism from blood cultures is very rare. We report a case of Nocardia infection that was isolated on blood cultures. A 59-year-old male with a medical history that includes a liver transplantation 6-years prior due to hepatocellular carcinoma secondary to chronic hepatitis B, developed pneumonia and was transferred to Severance Hospital. At the time of admission, the patient's initial exam showed hypothermia, tachypnea, and hypotension. His chest radiograph showed severe pneumonia and a large abscess on left upper lobe. Under the presumptive diagnosis of bacterial pneumonia or other opportunistic infection, we started broad spectrum antibiotics. However, he developed Nocardia sepsis, rapidly deteriorated, and subsequently died.

• Tuberculosis and Respiratory Diseases
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• v.71 no.5
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• pp.322-327
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• 2011

Background: Pneumocystis jirovecii is a fungus that has become an important cause of opportunistic infections. We present a summary of the clinical status and findings from bronchoalveolar lavage (BAL) of patients with Pneumocystis jirovecii pneumonia (PJP). Methods: We selected 30 cases of PJP that were proven through a surgical specimen evaluation. BAL fluid cytology was reviewed, and agreement with the initial diagnosis was evaluated. Results: All 30 cases of PJP occurred in immunocompromised patients. Only 15 of the 30 cases were initially diagnosed as PJP. We found PJP in 13 of the 15 cases that were negative at the initial diagnosis. The most characteristic finding of PJP was frothy exudates, and BAL fluid tended to show rare neutrophils. Two of seven patients with PJP and diffuse alveolar damage (DAD) revealed no frothy exudates in BAL fluid. Conclusion: BAL fluid cytology was reconfirmed as a sensitive and rapid method to diagnose PJP. We must be aware of the possibility of PJP to maintain high diagnostic sensitivity. We cannot exclude PJP in cases of PJP with DAD, even if frothy exudates are not observed in the BAL fluid.

• Journal of Chest Surgery
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• v.39 no.1 s.258
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• pp.85-89
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• 2006

Good's syndrome (thymoma with immunodeficiency) is a rare cause of combined B and T cell immunodeficiency in adults. The clinical characteristics are increased susceptibility to bacterial infection and opportunistic viral and fungal infections. The most consistent immunological abnormalities are hypogammaglobulinemia and reduced or absent B cells. This syndrome should be treated by resecting the thymoma and replacing the immunoglobulin to maintain adequate IgG values. The author experienced one case of Good's Syndrome. The patient was a 64-year-old female who had a history of frequent sinopulmonary infection. Chest CT showed Pneumonia and anterior mediastinal mass and PCNB was taken and biopsy result was thymoma. She received thymectomy and replacement of immunoglobulin to control hypogammaglobulinemia.

• Microbiology and Biotechnology Letters
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• v.38 no.1
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• pp.13-18
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• 2010

Past decade systemic mycoses caused by opportunistic human fungal pathogens, including Candida, Aspergillus, and Cryptococcus, have been a growing problem for both immunocompromised and immunocompetent individuals. Particularly, Cryptococcus neoformans has recently emerged as a major fungal pathogen, which can cause fungal pneumonia and meningitis that are lethal if not timely medicated. However, treatment for cryptococcosis has been difficult due to a lack of proper anti-cryptococcal drugs with fungicidal activity and less toxicity. In this review we introduced novel therapeutic methods for treating cryptococcosis by exploring pathogenomic signa1ing networks of C. neoformans with genome-wide transcriptome approaches as well as diverse molecular/genetic tools.

• Tuberculosis and Respiratory Diseases
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• v.61 no.6
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• pp.554-561
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• 2006

Background: In AIDS patients, the respiratory tract is one of the most frequently involved site of by an opportunistic infection, and an even common, casual pulmonary infection manifests in a peculiar ways in AIDS patients. In Korea, because of the low prevalence of AIDS, there is insufficient data compared with other Southeast Asian counties. However, considering the sexual behavior of the younger generation, it is expected that it will not be long before AIDS becomes a major public health issue in Korea. This study examined the clinical manifestation of HIV positive people and AIDS patients. The pulmonary manifestion of HIV-positive was evaluated. This study focused on the differences in the clinical manifestation between AIDS patients with pulmonary disease and simple HIV positive people. The characteristics of common pulmonary infections in AIDS patients were also analyzed. Method: The medical records of 28 HIV positive patients who visited the hospital of ChungAng University Hospital from January, 2001 to February, 2006 were analyzed retrospectively. Result: Twenty-seven patients out of 28 HIV positive patients were male and the average age was 40.6(23-65). Patients in their thirties were most commonly affected. Elven patients had pulmonary diseases. Pulmonary tuberculosis (4 cases) and pneumocystis pneumonia (4 cases) were the most common respiratory infection. One patient showed a peculiar type of systemic cryptococcus. which was accompanied by lung and pleural dissemination. The CD4+lymphocyte count of patients with a pulmonary infection was significantly lower in patients with a pulmonary manifestation than those with only a HIV infection ($79.5/mm^3$ vs $400/mm^3$, respectively)(p<.05). Patients with pulmonary disease were in a more severe immunosuppressive state. There were 4 patients with pulmonary tuberculosis, 4 with pneumocystis pneumonia, 4 with secondary syphilis, 2 with primary syphilis, and 2 with HZV infection. The average CD4 lymphocyte counts was $56/mm^3$ in those with pulmonary tuberculosis, $42/mm^3$ in those with pneumocystis pneumonia, and $455/mm^3$ in those with secondary syphilis. Conclusion: This study examined the clinical manifestation of HIV positive patients, particularly AIDS patients with pulmonary disease, A more severe immunosuppressive status was observed in HIV-related pulmonary compared with those with HIV-related extrapulmonary disease, and the frequency of pulmonary tuberculosis in pulmonary disease was higher than expected. Respiratory infection in AIDS manifest in uncommon ways e.g. disseminated cryptococcosis involving the lung and pleura. Evidently, AIDS patients with a respiratory infection have a more severe form of immunosuppression than those with a simple HIV infection. As expected, patients with a pulmonary infection were in a more severe immunosuppressed state than those with a simple HIV infection. Opportunistic infections can show peculiar clinical presentations in AIDS patients.

• Tuberculosis and Respiratory Diseases
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• v.45 no.4
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• pp.805-812
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• 1998

Background: Among the variety of opportunistic infections, pneumonia comprises the major morbidity in immunocompromised patients. Pneumocystis carnii pneumonia (PCP) and cytomegalovirus (CMV) pneumonia are common infectious illness of immunocompromised hosts. Although there are many reports regarding to the co-infection of PCP and CMV diagnosed by bronchoalveolar lavage (BAL) fluid examination, the effects of CMV co-infection on the outcome of PCP is still controversial. The purpose of this investigation is to evaluate the effects of CMV detected by BAL fluid examination on the clinical course of PCP in the immunocompromised patients other than human immunodeficiency virus infection. Method: Ten patients with PCP were enrolled and retrospective analysis of their medical records were done. HIV infected persons were excluded. The PCP was diagnosed by BAL fluid examination with Calcofluor-White staining. CMV was detected in BAL fluid by Shell-vial culture system. Chest radiographic findings were reviewed. We used Fisher's exact test and Mann-Whitney U test for statistical analysis of data. Results: The underlying disorders of patients were idiopathic pulmonary fibrosis (n=1), renal transplantation (n=4), necrotizing vasculitis (n=l), systemic lupus erythematosus (n=1), brain tumor (n=1), chronic myelogenous leukemia (n=1), unidentified (n=1). There were no difference in clinical course, APACHE III score, arterial blood gas analysis, white blood cell count, lymphocyte count, serum albumin concentration, chest radiographic findings and mortality between patients with PCP alone (n=4) and those with CMV co-infection (n=6). Univariate analysis regarding to the factors that associated with mortality of PCP were revealed that the application of mechanical ventilation (p=0.028), the level of APACHE III score (p=0.018) and serum albumin concentration (p=0.048) were related to the mortality of patients with PCP. Conclusion: The clinical course of PCP patients co-infected by CMV were not different from PCP only patients. Instead, accompanied respiratory failure, high APACHE III score and poor nutritional status were associated with poor outcome of PCP.

• Korean Journal of Veterinary Service
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• v.42 no.4
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• pp.201-216
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• 2019

Porcine reproductive and respiratory syndrome (PRRS) is characterized by reproductive failure in sows and respiratory distress in all age pigs. Porcine respiratory disease complex (PRDC) is a disease caused by opportunistic bacterial infection secondary to a weakened immune system by a preceding respiratory infection. In this study, we tried to compare the immune responses in PRRS and PRDC groups to clearly characterize the disease severity. Eighty-five pigs were infected with various Korean field PRRS virus strains. Infected animals were classified into PRRS (n=32) and PRDC (n=53) groups based on lung lesions such as interstitial pneumonia, suppurative pneumonia, and pleuropneumonia. The immune cell population of bronchoalveolar lavage cells (BALc) was evaluated on 14 and 28 days post infection (dpi) and PMBC cytokine expression was measured on 0, 3, 7, 14 dpi to investigate early inflammatory reactions. Pulmonary lesion severity was negatively correlated with alveolar macrophage (AM) in both PRRS and PRDC groups on 14 and 28 dpi. AM in BALc was less populated in PRDC group on 28 dpi compared to PRRS group. AM in BALc was significantly less populated in PRDC group on 28 dpi compared to 14 dpi. In addition, cytotoxic T lymphocyte (CTL) in BALc was higher populated in PRDC group on 14 dpi and 28 dpi compared to PRRS group. In the case of PBMC cytokine TNF-α, IFN-α, IL-1β, IFN-γ, FoxP3, and IL-2, the PRRS group showed higher expression than the PRDC group on 7 dpi, 14 dpi, 7 dpi, 14 dpi, 14 dpi, and 14 dpi, respectively. On the other hand, in the case of IFN-β, IL-6, IL-8, IL-4, and IL-17, the PRDC group showed higher PBMC cytokine expression at 14 dpi, 7 dpi, 14 dpi, 3 dpi, and 3 dpi, respectively, than the PRRS group. Based on these results, our study could characterize differential immune responses in pigs with PRRS or PRDC.

• Pediatric Infection and Vaccine
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• v.18 no.1
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• pp.97-102
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• 2011

The Multidrug-resistant Acinetobactor baumanii (MDRAB) is an opportunistic pathogen. Patients with long periods of hospital stay and/or under intensive care unit (ICU) receiving invasive management are more susceptible to this pathogen. In this report, four children with MDRAB infection are reviewed and described their clinical characteristics. There had been concurrent outbreaks of MDRAB infection in adult patients in the ICU at this period of time. The first child had received a craniotomy and epidural hematoma evacuation. The second child was admitted for status epilepticus with hydrocephalus. The third child had pneumonia with status epilepticus with hydrocephalus. The fourth child had poor activity due to hypoxic ischemic encephalopathy and convulsive disorder. Except the fourth child, all had not been exposed to carbapenem prior to infection of MDRAB. That imply the cause of MDRAB infections may be associated with invasive management and prolonged hospitalization together with the previous exposure to carbapenem in our cases. We would like to emphasize the importance and minimizing the spread of hospital infection in patients under prolonged intensive care management regardless of the use of carbapenem.