기관지 방선균증의 임상적 고찰
Diagnosis and Treatment of Endobronchial Actinomycosis
고원중 (성균관대학교)
서지영 (성균관대학교)
정만표 (성균관대학교)
김호중 (성균관대학교)
권오정 (성균관대학교)
권용수 (성균관대학교)
류연주 (성균관대학교)
유창민 (성균관대학교)
전경만 (성균관대학교)
강은해 (성균관대학교)
김태성 (성균관대학교)
이경수 (성균관대학교)
한정호 (성균관대학교)
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초록
배 경 : 기관지 방선균증은 매우 드문 질환이다. 본 연구는 최근 10년간 조직학적으로 진단된 7명의 기관지 방선균증 환자의 임상상과 치료에 대해 살펴보고자 하였다. 대상 및 방법 :1994년 10월부터 2003년 12월까지 삼성서울병원에 내원하여 기관지 방선균증으로 진단된 7명의 임상적, 방사선학적 특징과 치료에 대해 후향적 분석을 시행하였다.
- keywords
- Actinomycosis, Bronchoscopy, Anti-bacterial agents, Actinomycosis, Bronchoscopy, Anti-bacterial agents
Abstract
Background : Thoracic actinomycosis is a relatively uncommon anaerobic infection caused by Actinomyces israelii. There have been only a few case reports of endobronchial actinomycosis. The aim of this study was to evaluate the clinical manifestation and treatment of endobronchial actinomycosis. Material and Methods : Seven patients with endobronchial actinomycosis, who were diagnosed in the past 10 years, were retrospectively reviewed. Results : Cough and sputum were the most common symptoms. The chest radiograph and computed tomography showed necrotic consolidation (n=3), atelectasis (n=2), mass (n=1) and an endobronchial nodule (n=1). Proximal broncholithiasis was observed in five patients. All cases were initially suspected to have either lung cancer or tuberculosis. In these patients, the median duration of intravenous antibiotics was 3 days (range 0-12 days) and the median duration of oral antibiotics was 147 days (range 20-412 days). Two patients received oral antibiotic therapy only. There was no clinical evidence of a recurrence. Conclusion : Endobronchial actinomycosis frequently manifests as a proximal obstructive calcified endobronchial nodule that is associated with distal post-obstructive pneumonia. The possibility of endobronchial actinomycosis is suggested when findings of broncholithiasis are present at chest CT. The traditional recommendation of 2-6 weeks of intravenous antibiotics and 6-12 months of oral antibiotic therapy are not necessarily essential in all cases of endobronchial actinomycosis. (Tuberc Respir Dis 2005; 58: 576-581)
- keywords
- Actinomycosis, Bronchoscopy, Anti-bacterial agents, Actinomycosis, Bronchoscopy, Anti-bacterial agents
참고문헌
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