신이식 환자에서 발생한 Nocardia elegans 폐농양 1예
A Case of Lung Abscess Caused by Nocardia elegans in a Kidney Transplantation Recipient
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노카르디아는 면역 저하 환자에서 발생하는 기회 감염균으로 배양과 균 동정이 복잡하기 때문에 시기 적절한 진단과 치료가 어려울 때가 흔하다. 그러나 최근 16S 리보좀 RNA 염기서열 분석과 같은 새로운 분자생물학적 방법이 도입되면서 노카르디아 감염의 진단과 치료에 많은 도움이 되고 있다. 저자들은 신이식을 받은 39세 남자에서 발생한 N. elegans에 의한 폐농양을 경험하였기에 보고하는 바이다. 환자는 항균제 감수성 결과에 따라 적절한 항균제로 치료하였고, 치료 종료 후 1년 동안 재발 없이 외래 경과 관찰 중이다. 본 증례를 통하여 이식 환자와 같은 면역 저하 환자에서 노카르디아 감염의 가능성을 고려하여야 하겠고 분자생물학적 방법에 의한 빠른 균 동정과 적절한 항균제 치료가 중요함을 기억하여야 하겠다.
Abstract
Nocardiosis is well-known opportunistic infection in immunocompromised patients. The timely diagnosis and treatment, however, is still a difficult problem. Recently, as newer molecular techniques, particularly 16S rRNA sequencing, are implemented, the diagnosis and management of the infection are improving. We report a case of lung abscess in a 39-year-old-man who underwent kidney transplantation. He was diagnosed of Nocardia elegans by 16S rRNA sequencing and was cured of the infection with appropriate antibiotic therapy.
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