• Tuberculosis and Respiratory Diseases
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• v.69 no.5
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• pp.331-336
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• 2010

Background: Recently, the rate of infections with non-tuberculous mycobacteria (NTM) has been increasing in Korea. Precise identification of NTM is critical to determination of the pathogen and to target treatment of NTM patients. Methods: Sixty-eight unclassified mycobacteria isolates by rpoB PCR-RFLP assay (PRA) collected in 2008 were analyzed by National Center for Biotechnology Information (NCBI) Basic Local Alignment Search Tool (BLAST) search after sequencing of 16S rRNA, hsp65, rpoB genes. Results: Nineteen strains of 68 isolates were specified as species after sequencing analysis of 3 gene types. We found 3 M. lentifulavum, 5 M. arupense, 4 M. triviale, 4 M. parascrofulaceum, and one M. obuense. One M. tuberculosis and another M. peregrinum were mutated at the Msp I recognition site needed for rpoB PRA. The remaining 49 isolates did not coincide with identical species at the 3 kinds genes. Conclusion: Sequencing analysis of 16S rRNA, hsp65, rpoB was useful for identification of NTM unclassified by rpoB PRA.

• Tuberculosis and Respiratory Diseases
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• v.75 no.6
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• pp.260-263
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• 2013

Invasive aspergillosis has emerged as a major cause of life-threatening infections in immunocompromised patients. Recently, patients with chronic obstructive pulmonary disease, who have been receiving corticosteroids for a long period, and immunocompetent patients in the intensive care unit have been identified as nontraditional hosts at risk for invasive aspergillosis. Here, we report a case of invasive pulmonary aspergillosis after influenza in an immunocompetent patient. The patient's symptoms were nonspecific, and the patient was unresponsive to treatments for pulmonary bacterial infection. Bronchoscopy revealed mucosa hyperemia, and wide, raised and cream-colored plaques throughout the trachea and both the main bronchi. Histologic examination revealed aspergillosis. The patient recovered quickly when treated systemically with voriconazole, although the reported mortality rates for aspergillosis are extremely high. This study showed that invasive aspergillosis should be considered in immunocompetent patients who are unresponsive to antibiotic treatments; further, early extensive use of all available diagnostic tools, especially bronchoscopy, is mandatory.

• Tuberculosis and Respiratory Diseases
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• v.49 no.1
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• pp.117-121
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• 2000

The mucormycosis is a group of serious opportunistic infections caused by fungi of the class Zygomycetes and order Mucorales. Pulmonary mucormycosis is a relatively rare disease but typically manifested by a rapidly progressive, often fatal pneumonia in patients with diabetes mellitus, hematologic malignant neoplasms, or organ transplants. The radiologic manifestations of pulmonary mucormycosis are nonspecific and include progressive lobar or multilobar consolidations, pulmonary masses and pulmonary nodules. Recently, we experienced a pulmonary mucormycosis in 32-year-old man with uncontrolled diabetes. He complained of cough, left pleuritic chest pain and generalized weakness. Initial chest X-ray finding was the consolidation on the lower lobe of the left lung. On the sixth hospital day, bronchoscopic examination with lung biopsy revealed broad, non-septate hyphae with right-angle branching, diagnostic of mucormycosis, and consequently amphotericin B therapy was started. We performed a lobectomy of the left lower lobe of the lung on 29th hospital day.

• Tuberculosis and Respiratory Diseases
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• v.66 no.6
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• pp.463-466
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• 2009

Streptococcus constellatus (S. constellatus) is a commensal microorganism belonging to the "Streptococcus milleri" group, but may cause infections in different locations in immunocompromised patients. The infection of S. constellatus has high mortality and morbidity due to its tendency to cause abscesses in infected patients, which require immediate surgical drainage for effective treatment. We report on a 72-year-old woman with end stage renal disease, who suffered from dyspnea and general weakness that had developed over 7 days. Chest CT showed loculated pleural effusion. S. constellatus was cultured from exudative pleural effusions and confirmed by an analysis of 16S rRNA sequence. The patient was treated with drainage of pleural effusion and piperacillin/tazobactam for 5 weeks.

• Tuberculosis and Respiratory Diseases
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• v.74 no.4
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• pp.187-190
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• 2013

We report a rare case of lung disease caused by Mycobacterium lentiflavum in a previously healthy woman. A 54-year-old woman was referred to our hospital due to chronic cough and sputum. A computed tomography scan of the chest revealed bilateral bronchiectasis with bronchiolitis in the right middle lobe and the lingular division of the left upper lobe. Nontuberculous mycobacteria were isolated twice from three expectorated sputum specimens. All isolates were identified as M. lentiflavum by multilocus sequence analysis based on rpoB, hsp65, and 16S rRNA fragments. To the best of our knowledge, this is the first documented case of M. lentiflavum lung disease in an immunocompetent adult in Korea.

• Journal of Life Science
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• v.19 no.10
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• pp.1451-1455
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• 2009

Porcine cytomegalovirus (PCMV) is a betaherpesvirus which causes reproductive failure in breeding sows and generalized infection in newborn piglets. It has worldwide distribution including Korea. Serological survey on this virus has been reported in 76.3% of pigs, but virological survey and epidemiological analysis on PCMV distribution have been reported in only a few papers in Korea. In this study, we investigated the virological prevalence and infection status of PCMV on a farm level in selected swine farms with respiratory diseases. A total of 1,938 blood samples taken from groups of pigs of different ages were collected from 31 farms distributed nationwide in 2006 and 2007 and tested by PCR to detect the presence of PCMV. Virological prevalence at farm level and pig level were 96.8% and 17.5%, respectively, suggesting that PCMV has endemically infected Korean pig herds. The prevalence at farm level in gilts, sows and suckling piglet groups were 16.7%, 36.7% and 56.7%, indicating that vertical infections frequently occurred in conception or newborn stage. Thereafter, detection rates of PCMV were slightly increased in pig groups aged 40 and 70 days (70.0% and 73.3%), and then gradually decreased as they aged - 33.3% in 100, 26.7% in 130 and 16.7% in 160 day old pig groups. The prevalence at pig level has similar patterns to that at farm level. With the passage of time, the variation of infection patterns of PCMV was investigated in four PCMV-positive farms. Three blood samples were collected at intervals of 6 months in each farm, and examined for presence of PCMV using PCR. The results revealed that once PCMV was introduced to the pig farms, it continuously circulated between and within groups of sows and piglets in those farms. Taken together, it can be concluded that PCMV has endemically infected Korean pig farms and has the potential risk for emerging pathogen in combination with the known endemic pathogens including porcine reproductive, respiratory syndrome virus and porcine circovirus type 2. Therefore, more research is needed on diagnosis, epidemiology and control strategy for PCMV on the field.

• Korean Journal of Veterinary Service
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• v.30 no.1
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• pp.51-66
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• 2007

The purpose of this study was to evaluate the effect of a subsequent infection of porcine reproductive and respiratory syndrome(PRRS) virus to pigs with A pleuropneumonia. Twenty three 7-week-old commercial pigs were infected intratracheally with PRRS virus and/or A pleuropneumoniae serotype 5. Serum antibody titers were examined by an enzyme-linked immunosorbent assay(ELISA) and proportion of porcine leukocyte subpopulations in peripheral blood was examined by flow cytometry. In this experiment, antibodies against PRRS virus and A pleuropneumoniae were detected at 2 weeks and 1 week postinfection and the number of antibody positive pigs were gradually increased. And in proportion to leukocyte subpopulations in peripheral blood of pigs infected with A pleuropneumoniae compared with pigs administrated with saline, the proportion of PoCD4 and N cells were increased(P<0.1). Furthermore, in proportion to leukocyte subpopulations in peripheral blood of pigs infected with PRRS virus followed by A pleuropneumoniae compared with pigs administrated with saline, the proportion of MHC class II, PoCD4 and B cells were significantly increased(P<0.1). The results indicated that dual infection with PRRS virus and A pleuropneumoniae induced the stronger immune responses associated with macrophages and Th cells in pigs than single infection with PRRS virus or A pleuropneumoniae.

• Tuberculosis and Respiratory Diseases
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• v.50 no.3
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• pp.359-366
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• 2001

More than half of the cryptococcal infections occur in acquired immune deficiency (AIDS) patients, and more than half of the non-AIDS patients with cryptococcosis are immunocompromised. Most immunocompromised patients have meningoencephalitis at the time of diagnosis. Without the appropriate therapy, this form of the infection is invariably fatal. Death can occur any time from 2 weeks to several years after the onset of symptoms. Pulmonary cryptococcosis in immunocompromised patients is usually asymptomatic, but coughing, chest pain, fever, or hemoptysis may occur in immunocompetent patients. Pulmonary cryptococcosis symptoms in immunocompetent patients tend to improve without treatment. Here, we describe the various pulmonary manifestations of cryptococcal pneumoniae in three immunocompetent patients.

• 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.

• Pediatric Infection and Vaccine
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• v.13 no.2
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• pp.201-205
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• 2006

Immunodeficiency affected by antibody formation is most common among primary immuno-deficiencies. Selective IgA deficiency is more common but, one or more IgG subclass level is low or deficient in some patients. Patients with antibody production deficiency are vulnerable to pneumococci, staphylococci and H.influenzae leading to sinusitis, otitis media and pneumonia. A 10-year-old girl had suffered from frequent upper respiratory infections, a history of tuberculous lymphadenitis tuberculosis medication, and frequent pneumonia that requires hospital adimission. Her height and weight were below 3 percentile normal growth as a manifestation of failure to thrive. When she had another severe pneumonia, all the immunologic test was normal at first, and then we checked the IgG subclass levels. Her IgG1 was within normal, IgG2 was very low, IgG3 and IgG4 was not detected. We report a case of IgG subclass deficiency in frequent upper respiratory infection and failure to thrive.