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비브리오 패혈증

Vibrio Vulnificus Sepsis

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초록

패혈증 비브리오균 감염은 위장염에서부터 일차성 패혈증(primary sepsis)과 창상감염으로 발현하고, 이 중 일차성 패혈증이 가장 흔하며, 패혈증의 경우 사망률이 50% 이상으로 매우 치명적인 질환이다. 그러므로 질환의 역학과 임상양상을 신속하게 파악하여 조기 진단을 하고 그에 따른 신속한 수술적 처치 및 항생제 투여가 필요하다. 비브리오 패혈증 환자가 응급실 내원 후 항생제 투여되는 시간이 지연되는 경우를 가끔씩 경험한다. 치료 지연의 대부분은 진단을 못해서라기 보다는 검사 시행으로 인한 치료 지연이 대부분이다. 마지막으로 당부하고자 하는 것은 혈액 검사 및 영상 검사 시행을 위해 항생제 투여나 수술적 처치가 늦어지지 않도록 각별한 주의를 강조하고 싶다.

Abstract

Vibrio vulnificus (V. vulnificus) is a halophilic motile, gram-negative rod which can cause fatal human infections. The spectrum of illness caused by V. vulnificus is gastroenteritis, primary sepsis, and wound infection. Most of patients infected with V. vulnificus have at least one risk factor such as chronic liver diseases, immunocompromiased hosts, hematologic disorders characterized by elevated iron level. V. vulnificus infection is suspected by clinical and epidemiological history. Radiological studies of affected lesions are helpful to diagnosis of necrotizing soft tissue infection. The definitive diagnosis is made by the isolation of V. vulnificus from blood and wound cultures. The mortality of V. vulnificus primary sepsis is above 50%, so early diagnosis, early surgical debridement and administration of appropriate antibiotics is essential. (Korean J Med 2012;82:671-679)

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