소아에서의 흉벽 천공성 농흉(Empyema Necessitatis) 1례
A Case of Empyema Necessitatis in a Child
2
조회
0
다운로드
0
인용
0
참고문헌
초록
성인에서 드물게 보고되는 흉벽 천공성 농흉(empyema necessitatis)은 면역저하인 경우에서 잘 발생하고, 원인으로는 결핵인 경우가 많다. 본 환아는 처음에는 결핵에 대한 노출병력 등으로 결핵이 의심되었으나 항생제로 잘 치료되어 검사 결과와 항생제에 반응하는 임상 경과를 종합해 볼 때 원인균으로 연쇄상구균이 의심이 되었다. 저자들은 면역이 정상인 소아에서 국내에서 보고된 바가 없는 흉벽, 종격동, 심막까지 침범된 농흉의 합병증인 흉벽 천공성 농흉 1례를 경험하였기에 보고하는 바이다.
Abstract
Empyema necessitatis, which is a rare complications of empyema especially in immunocompromised conditions, extends pus from the thoracic cavity into surrounding soft tissues. The causes of empyema necessitatis are fungal infection, pulmonary tuberculosis and various types of pneumonia. A 9-year-old boy presented with a 7 day history of anterior chest pain and a coin sized palpable mass. Physical examination revealed a papable egg sized erythematous mass above the areola of the left chest. Laboratory data revealed acute inflammation. CT scans of chest demonstrated acute inflammation from the left anterior chest to the mediastinum and pericardium. He underwent sono guided thoracentesis and percutaneous aspiration of the mass and no organisms grew in a culture of pleural fluid and percutaneous aspiration. Tuberculin skin test was negative. The child was treated with antibiotics. Then, pain and the size of the mass decreased, follow up results of CT were resolved and he was discharged with oral antibiotics. We experienced a rare case of empyema necessitatis in 9-year-old child who was immunocompetent.
참고문헌 (16)
- Sindel EA, "Empyema necessitatis", 6, pp.1~49 (1940)
- Perez-Castrillon JL, "Empyema necessitatis due to Actinomyces odontolyticus", 111, pp.1144~ (1997)
- Kang EY, "Ultrasonographic findings of tuberculous empyema necessitatis", pp.113~6
- Henschke CI, "The pathogenesis,radiologic evaluation,and therapy of pleural effusions", 27, pp.1241~55 (1989)
- Haddad CJ, "Empyema necessitatis", 10, pp.149~52 (1989)
- Baillou, "Libri epidemiorum et ephemeridorum"
- Hochberg LA, "A study of 300 cases of acute empyema thoracics", 10, pp.354~ (1941)
- Tasdan Y, "Chest wall abscess as an unusual presentation of childhood tuberculosis", 17, pp.85~6 (1998)
- Chen CH, "Tuberculous subcutaneous abscess:an analysis of seven cases", 77, pp.184~7 (1996)
- Glicklich M, "Tuberculous empyema necessitatis computed tomographic findings", 14, pp.23~35 (1990)
- Bhatt GH, "CT demonstration of empyema necessitatis", pp.1108~9
- Matheson A, "Empyema necessitatis", 49, pp.330~1 (1932)
- Denlinger CE, "Acquired systemic-to-pulmonary arteriovenous malformation secondary to Mycobacterium tuberculosis empyema", 74, pp.1229~31 (2002)
- Gupta JP, "Tuberculous empyema necessitatis with a rib floating in pleural cavity", 82, pp.412~3 (1984)
- Noyes BE, "Pseudomonas cepacia empyema necessitatis after lung transplantation in two patients with cystic fibrosis", 105, pp.1888~91 (1994)
- Freeman AF, "Streptococcus pneumoniae empyema necessitatis", 23, pp.177~9 (2004)