진행된 HIV 감염 환자에서 십이지장의 미란성 병변으로 발현한 Mycobacterium genavense 감염 1예
A Case of Mycobacterium genavense Infection that Manifested as an Erosive Lesion of Duodenum in a Patient with Advanced HIV Infection
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초록
Mycobacterium genavense는 최근에 알려진 미코박테륨으로서, 식욕 부진, 체중 감소, 설사, 림프절 병증 등 파종성 Myocobacterium avium-intracellulare complex 감염과 유사한 임상상을 보이며, 위장관 침범을 잘 하는 것으로 알려져 있으나 아직 국내에서 증례는 보고된 바가 없다. 저자들은 진행된 HIV 감염 환자에서 십이지장의 미란성 병변으로 발현한 Mycobacterium genavense 감염 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. 환자는 상복부 동통과 발열, 설사로 내원하였다. 십이지장의 미란성 병변에서 시행한 조직검사에서 항산균이 가득 차 있는 거품세포가 관찰되었으며, 이 검체에서 16S rRNA 유전자의 중합연쇄반응 검사를 시행하여 Mycobacterium genavense를 확인하였다.
Abstract
Mycobacterium genavense, first identified in 1990, is known as a pathogen that mimics disseminated Myocobacterium avium-intracellulare complex (MAC) infection with particular propensity for the gastrointestinal tract. In Korea, no case with the organism has been reported. Herein we report a case of Mycobacterium genavense infection that manifested with erosive lesion of duodenum in a patient with acquired immune deficiency syndrome. The patient presented with epigastric pain and fever, diarrhea. Duodenal biopsy showed histiocytic infiltration with numerous acid-fast bacilli. Identification of the mycobacterial isolate by the polymerase chain reaction restriction analysis of 16S rRNA gene revealed Mycobacterium genavense.
참고문헌 (9)
- Edwards U, "Isolation and direct complete nucleotide determination of entire genes Characterization of a gene coding for 16S ribosomal RNA", 17, pp.7843~7853 (1989)
- Chang HR, "Fatal infection with a novel unidentified mycobacterium in a man with the acquired immunodeficiency syndrome", pp.109~13 (1990)
- Pech re M, "Clinical and epidemiologic features of infection with Mycobacterium genavense", 155, pp.400~404 (1995)
- Shafran SD, "Disseminated Mycobacterium genavense infection in Canadian AIDS patients", 76, pp.168~170 (1995)
- Yan JJ, "Disseminated Mycobacterium genavense infection in a patient with acquired immunodeficiency syndrome first case report in Taiwan", 98, pp.62~65 (1999)
- Maschek H, "autopsy findings in three patients", pp.95~9 (1994)
- Teske A, "infection in patients with AIDS", pp.76~340 80 (1992)
- Griffith DE, "ATS Mycobacterial Diseases Subcommittee; American Thoracic Society; Infectious Disease Society of America : An Official ATS", IDSA Statement: Diagnosis, Treatment, and Prevention of Nontuberculous Mycobacterial Diseases, 2007, pp.175, 367~416
- Koehler M, "Endoscopic appearance of Mycobacterium genavense case report and review of the literature", 44, pp.331~333 (1996)