황색포도알균에 의한 다발성 화농성 근염 1예
A Case of Multifocal Pyomyositis by Staphylococcus aureus
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초록
화농성 근염은 골격근의 급성 세균성 감염 질환으로서 당뇨, 인면역결핍바이러스 감염, 항암 치료중인 종양 환자 등 처럼 면역력이 떨어진 환자가 아닌 경우라면 온대 기후 지방에서는 드문 질환이다. 한국에서 보고된 화농성 근염의 경우 단발성 혹은 1-2개정도의 근육에만 국한된 경우가 대부분이었다. 본 증례는 흉부, 복부, 골반 부위 등의 다발성 근육을 침범하였다. 병변에서 흡인한 농에서 황색포도알균이 분리되었다. 진단과 치료의 지연은 황색포도알균의 다발성 화농성 근염을 악화시켰다. 세파졸린 항생제의 투여 및 적절한 배농술을 통해 약 1개월 이후 환자는 완전히 회복되었다.
Abstract
Pyomyositis, the suppurative infection of skeletal muscle, is rarely found in areas of temperate climates unless the patients have immune suppressing conditions such as diabetes, human immunodeficiency viral infection, or chemotherapy. Most reported pyomyositis cases in Korea showed localized involvement in only one or two muscles. Previously, no case of pyomyositis with multifocal metastatic dissemination has been reported in Korea. This case of pyomyositis in 51 year old man involved multiple muscles including the chest wall muscles, abdominal muscles and pelvic muscles. Pus culture results revealed Staphylococcus aureus as the causative organism. Delayed diagnosis and prior treatment of two months before visiting our hospital were considered as the causes for the metastatic dissemination of the organism. After 1 month of treatment with aggressive surgical drainage and intravenous cefazolin the patient fully recovered.
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