해외여행 후 장티푸스와 A형 간염이 동시에 감염된 1예
A Case of Co-infection of Salmonella typhi and Viral Hepatitis A after Traveling Abroad
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장티푸스와 A형 간염은 모두 개발도상국에서 흔히 발생하는 수인성 감염으로 유행지역으로 여행하기 전의 개인위생교육과 예방접종이 중요한 질환이다. A형간염은 임상증상이있은 후에도 1-2주의 window period를 가지므로 A형간염이임상적으로 의심될 때는 IgM anti-HAV가 음성이더라고 1-2주후에 재검하여 다시 확인해 봐야한다. 저자들은 해외여행 후발열을 주소로 입원하여 혈액배양 검사에서 장티푸스로 진단된 환자가 바이러스성 간염에 대한 검사에서 음성의 결과를보였다가 급격하게 간수치가 증가하면서 재검사한 Anti-HAV IgM에서 양성의 결과를 보여 장티푸스와 A형 간염의 동시감염이 진단된 환자 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
Infectious diseases imported from other countries have increased. Feco-oral route is the most common mode of transmission for both typhoid fever and hepatitis A, and thus infection by these agents have an association with poor sanitation. A 30-year-old male was visited to the hospital because of high fever after traveling in Thailand. The level of hepatic transaminases were mildly elevated and viral serological marker for hepatitis was negative. The blood culture was reported positive for Salmonella typhi. After a few days, the level of hepatic transaminases rapidly increased and viral serological marker for hepatitis became positive with anti-hepatitis A viral IgM at follow-up. Therefore we report a case of co-infection of S. typhi and viral hepatitis A after traveling abroad.
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