특이 과거력이 없는 소아에서 발생한 Parvimonas micra 뇌농양 1예
A Case of Brain Abscess due to Parvimonas micra in a Healthy Child without Dental Disease
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초록
Parvimonas micra는 아포 비형성 혐기성 그람 양성 알균으로, 피부, 잇몸, 질, 위장관 등에 정상 상재균으로 존재하며 주로 치과 치료 등의 침습적 치료 후 기회 감염을 일으킬 수 있다. 저자들은 최근 1년 이내 치과 질환을 포함한 특이 과거력이 없는 11세 소아에서 P. micra에 의해 발생한 뇌농양을 경험하여 보고하고자 한다. 환자는 내원 7일 전부터 두통, 구토가 발생하였으며, 내원일 복시가 발생하였다. 뇌 자기공명영상에서 좌측 전두정엽 뇌농양으로 진단한 후 수술적 배농을 시행하였으며, 수술 시 흡인한 검체의 혐기성 세균 배양 검사에서 P. micra가 동정되었다. 수술 후 6주간 ceftriaxone과 metronidazole 항생제 병합요법으로 치료한 후 재발 없이 안정된 상태를 보이고 있다.
Abstract
Parvimonas micra is a non-spore-forming anaerobic gram-positive coccus and a known commensal of the skin, gums, vagina, and gastrointestinal tract. It is rarely associated with severe infections, which typically follow invasive procedures such as dental treatment. We describe a case of a brain abscess caused by P. micra in an immunocompetent 11-year-old boy without periodontal disease. He presented with a 7-day history of headaches and vomiting, and complained of diplopia that began on the day of presentation. He did not have any recent dental treatment or specific past medical history. A brain abscess in the left frontoparietal lobe was noted on brain magnetic resonance imaging. P. micra was cultured from brain abscess aspirate. He was successfully treated with surgical drainage and combined antibiotic therapy with ceftriaxone and metronidazole for 6 weeks.
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