• Title/Summary/Keyword: Pulmonary infection

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Fatal Clinical Course of Probable Invasive Pulmonary Aspergillosis with Influenza B Infection in an Immunocompetent Patient

  • Park, Dong Won;Yhi, Ji Young;Koo, Gunwoo;Jung, Sung Jun;Kwak, Hyun Jung;Moon, Ji-Yong;Kim, Sang-Heon;Kim, Tae Hyung;Sohn, Jang Won;Shin, Dong Ho;Park, Sung Soo;Yoon, Ho Joo
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.3
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    • pp.141-144
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    • 2014
  • Invasive pulmonary aspergillosis (IPA) is rarely reported in patients who have normal immune function. Recently, IPA risk was reported in nonimmunocompromised hosts, such as patients with chronic obstructive pulmonary disease and critically ill patients in intensive care units. Moreover, influenza infection is also believed to be associated with IPA among immunocompetent patients. However, most reports on IPA with influenza A infection, including pandemic influenza H1N1, and IPA associated with influenza B infection were scarcely reported. Here, we report probable IPA with a fatal clinical course in an immunocompetent patient with influenza B infection. We demonstrate IPA as a possible complication in immunocompetent patients with influenza B infection. Early clinical suspicion of IPA and timely antifungal therapy are required for better outcomes in such cases.

The Clinical Manifestation of Pulmonary Infection in AIDS Patients (국내 일개 대학병원에서 경험한 AIDS 환자의 폐 감염성 질환의 임상적 특성)

  • Jung, Jae Woo;Chung, Jin Won;Song, Ju Han;Jeon, Eun Ju;Lee, Young Woo;Choi, Jae Cheol;Shin, Jong Wook;Park, In Whon;Choi, Byoung Whui;Kim, Jae Yeol
    • 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.

Usefulness of CT-Guided Percutaneous Transthoracic Needle Lung Biopsies in Patients with Suspected Pulmonary Infection

  • Junghoon Kim;Kyung Hee Lee;Jun Yeun Cho;Jihang Kim;Yoon Joo Shin;Kyung Won Lee
    • Korean Journal of Radiology
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    • v.21 no.5
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    • pp.526-536
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    • 2020
  • Objective: This study aimed to evaluate the clinical benefits and risks of CT-guided percutaneous transthoracic needle lung biopsies (PTNBs) in patients with a suspected pulmonary infection. Materials and Methods: This study included 351 CT-guided PTNBs performed in 342 patients (mean age, 58.9 years [range, 17-91 years]) with suspected pulmonary infection from January 2010 to December 2016. The proportion of biopsies that revealed the causative organism for pulmonary infection and that influenced patient's treatment were measured. Multivariate analyses were performed to identify factors associated with PTNB that revealed the causative organism or affected the treatment. Finally, the complication rate was measured. Results: CT-guided PTNB revealed the causative organism in 32.5% of biopsies (114/351). The presence of necrotic components in the lesion (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.1-2.7; p = 0.028), suspected pulmonary tuberculosis (OR, 2.0; 95% CI, 1.2-3.5; p = 0.010), and fine needle aspiration (OR, 2.5; 95% CI, 1.1-5.8; p = 0.037) were factors associated with biopsies that revealed the causative organism. PTNB influenced patient's treatment in 40.7% (143/351) of biopsies. The absence of leukocytosis (OR, 1.9; 95% CI, 1.0-3.7; p = 0.049), presence of a necrotic component in the lesion (OR, 2.4; 95% CI, 1.5-3.8; p < 0.001), and suspected tuberculosis (OR, 1.7; 95% CI, 1.0-2.8; p = 0.040) were factors associated with biopsies that influenced the treatment. The overall complication rate of PTNB was 19% (65/351). Conclusion: In patients with suspected pulmonary infection, approximately 30-40% of CT-guided PTNBs revealed the causative organism or affected the treatment. The complication rate of PTNB for suspected pulmonary infection was relatively low.

Prevalence and Risk Factors for Mycobacterium tuberculosis Infection among Contacts of Pulmonary Tuberculosis Patients (폐결핵환자 접촉자에서 결핵감염의 빈도와 결핵감염의 위험인자)

  • Park, Jae-Seuk
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.2
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    • pp.140-148
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    • 2012
  • Background: Detection and treatment of tuberculosis (TB) infection with contact investigation is a key component of TB control program. I evaluated the prevalence and risk factors for TB infection among contacts of recently diagnosed pulmonary TB patients in a tertiary hospital in Korea. Methods: 206 contacts of 90 adult pulmonary TB patients underwent tuberculin skin tests (TST) and chest radiography. The TST results were considered positive with an induration of 10 mm or more, suggesting TB infection. A standardized questionnaire was used to assess risk factors associated with TB infection. Results: TST was positive in 97 of 206 contacts of TB patients (47.1%) and positive rate of TST increased with age. The risk of TB infection was significantly associated with close contact with TB patients (sleeping in the same room) (odd ratio [OR], 4.94; 95% confidence interval [CI], 1.43~17.00). Conclusion: TB infection rate was higher in the elderly, and the risk of TB infection was significantly increased with close contact of TB patients.

Pulmonary Infection with Mycobacterium Celatum in Immunocompetent Host: The First Case Report in Korea (면역적격성인에서 발생한 Mycobacterium celatum 폐 감염증 1예)

  • Kim, Deog-Kyeom;Kim, Bum-Joon;Kook, Yoon-Ho;Lee, Chun-Taek;Yoo, Churl-Gyoo;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.5
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    • pp.697-703
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    • 1999
  • Mycobacterium celatum is a recently described nontuberculous mycobacterium. Even though pulmonary or lymphatic infection cases were reported previously in human, the clinical significance of the infection with M. celatum is not yet understood completely. Mast infections with this species occurred in the patients with suppressed cell-mediated immunity such as AIDS, and there are only a few cases of pulmonary infection with M. celatum in immunocompetent adults or infants in the world. In Korea, mycobacterial pulmonary infection is a major problem of respiratory disease but, there has been no pulmonary infection with M. celatum reported. We report, to our knowledge, the first Korean case of pulmonary infection with M. celatum, which was identified by rpoB genomic sequencing.

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A Case of Pulmonary and Endobronchial Mycobacterium avium Infection Presenting as an Acute Pneumonia in an Immunocompetent Patient (면역 적격자에서 급성 폐렴으로 발현된 폐실질 및 기관지를 침범한 Mycobacterium avim 감염 1예)

  • Lee, Yu-Jin;Kim, Dong-Hyun;Yoon, Kyung-Hwa;Kim, Mi-Young;Jung, Seung-Wook;Lee, Byung-Ki;Kim, Yeon-Jae
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.4
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    • pp.279-283
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    • 2010
  • The global number of Mycobacterium avium complex (MAC) pulmonary infection is increasing. Patients with preexisting lung disease or who are immunodeficient are at the greatest risk for developing MAC infection. Endobronchial lesions with MAC infection are rare in the immunocompetent host. However, there have been an increasing number of reports of an immunocompetent host being afflicted with various manifestations of MAC infection. We report a case of pulmonary and endobronchial MAC infection presenting as an acute pneumonia in a 59-year-old female without preexisting lung disease or immunodeficiency.

Medical Imaging and Nuclear Molecular Imaging Probes for Pulmonary Fibrosis Diagnosis

  • Heesu Ahn;Yong Jin Lee
    • Journal of Radiopharmaceuticals and Molecular Probes
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    • v.8 no.2
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    • pp.103-111
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    • 2022
  • Idiopathic pulmonary fibrosis (IPF) is a progressive disease caused by some risk factors, including smoking, viral infection, toxic substances, and radiation, that decline lung function of fresh oxygen and blood delivery throughout the body. Patients with pulmonary fibrosis have suffered from breathing and cough and the average survival rate is only 3 years after diagnosis. Therefore, it is significant to diagnose IPF and start treatment in enough time. Usually, lung biopsy is available to diagnose localized pulmonary fibrotic sites directly. However, it is insufficient to visualize whole lung tissue, and also it has a risk of infection for patients. In the clinic, medical imaging systems can diagnose pulmonary fibrosis non-invasively without infection. In this review, we introduce current medical imaging systems used to diagnose pulmonary fibrosis, including CT, MRI, and nuclear medicine. Further, we introduce several molecular imaging probes targeting specific biomarkers which are expressed in pulmonary fibrosis. Through this paper, it is expected that it would be helpful to understand the latest knowledge and research trends on pulmonary fibrosis diagnostic imaging.

Pulmonary Cryptococcosis -Report of 2 cases - (폐 효모균증 -2예 보고 -)

  • 김병호;허동명;손경락;김익수;이병기;김연재;신현웅
    • Journal of Chest Surgery
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    • v.37 no.3
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    • pp.292-296
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    • 2004
  • Cryptococcus neoformans is a ubiquitous fungus found worldwide, particularly in soil contaminated by pigeon drop- pings. Pulmonary cryptococcosis occurs rarely in immunocompetent individuals. The risk of cryptococcal infection increases with the degree of immunal compromise, in human immunodeficiency virus infection especially. Pulmonary cryptococcosis is most frequently encountered as asymptomatic single or multiple pulmonary nodules found by routine chest x-ray examination. The diagnosis is most often made in these situations by the histology of the resected lesion. Acute progressive pneumonia may occur, with symptoms of cough, sputum production, fever, and weakness. The clinical picture is not pathognomonic. The yeasts are stained well by any of the special stains for fungi. Treatment is now indicated for all cases given a diagnosis of cryptococcosis, even if the diagnosis has been made by resecton of a solitary, asymptomatic pulmonary nodule.

Mixed Infection of Mycobacterium abscessus subsp. abscessus and Mycobacterium tuberculosis in the Lung

  • Sohn, Sungmin;Wang, Sungho;Shi, Hyejin;Park, Sungrock;Lee, Sangki;Park, Kyoung Taek
    • Journal of Chest Surgery
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    • v.50 no.1
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    • pp.50-53
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    • 2017
  • A mixed infection of Mycobacterium abscessus subsp. abscessus (Mab) and Mycobacterium tuberculosis (MTB) in the lung is an unusual clinical manifestation and has not yet been reported. A 61-year-old woman had been treated for Mab lung disease and concomitant pneumonia, and was diagnosed with pulmonary tuberculosis (PTB). Despite both anti-PTB and anti-Mab therapy, her entire left lung was destroyed and collapsed. She underwent left pneumonectomy and received medical therapy. We were able to successfully treat her mixed infection by pneumonectomy followed by inhaled amikacin therapy. To the best of our knowledge, thus far, this is the first description of a mixed Mab and MTB lung infection.

Dyspnea Due to Candidal Septic Pulmonary Embolism Originated from Odontogenic Infection (치성감염에서 유래한 칸디다성 폐색전증으로 인한 호흡곤란)

  • Jeong, Ki-Hyun;Cho, Hyun-Jae;Jang, Kun-Soo;Jeon, Jae-Yun;Shim, Kwang-Sup;Hwang, Kyung-Gyun;Park, Chang-Joo
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.2
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    • pp.115-117
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    • 2014
  • Septic pulmonary embolism is a rare disease entity that consists of pulmonary infection and embolism predominantly arising from endocarditis and thrombophlebitis. We report a rare case of candidal septic pulmonary embolism secondary to odontogenic infection in a previously healthy and immunocompetent man, who had a submandibular abscess with dyspnea and fever. The patient was not responsive to prolonged broad spectrum antibiotics and surgical drainage, however, antifungal therapy was successful after Candida albicans was confirmed by his blood culture. Since proper identification and the resolution of the septic origin is as important as the diagnosis of septic pulmonary embolism, in a patient with odontogenic infection, who shows definite respiratory complications despite antimicrobial therapy with surgical drainage, various culture examinations should be adopted.