부검을 통해 확진된 비브리오 불니피쿠스(Vibrio vulnificus) 패혈증 1예
Autopsy case: Vibrio vulnificus sepsis confirmed by autopsy
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초록
Vibrio vulnificus에 의한 패혈증은 약 30%에서 저혈압성의 쇼크를 보이며 이 중 90% 정도의 사망을 보이는 치명적인 질환으로, 이 균에 의한 감염은 알려진 간질환자나 면역저하자의 경우가 대부분인데 반해 저자들은 기저 질환을 알지 못하던 환자가 내원 후 빠르게 저 혈압성 쇼크, 괴사성 근막염의 소견을 보이면서 6시간 만에 사망하였고, 이후 부검소견, 조직배양 및 혈액배양을 통해 V. vulnificus의 감염을 확진한 드문 예를 경험하였다. Vibrio vulnificus에 의한 원발성 패혈증 환자에서 병리 조직 소견의 국내 보고는 없어 임상양상과 부검을 통한 감염의 병리 소견을 포함하여 저자들이 경험한 1예를 보고하고자 한다.
Abstract
Vibrio vulnificus primary septicemia is a serious illness associated with high mortality rates and is caused by the ingestion of raw or undercooked shellfish. Most patients admitted with V. vulnificus infection are immunocompromised or have an underlying disease, such as liver cirrhosis or hemochromatosis. In contrast, the authors experienced an uncommon case in which a patient with no known underlying disease rapidly progressed to sepsis with hypotensive shock, followed by death within a few hours. Based on a postmortem examination, tissue cultures, and blood cultures, it was determined that the patient had been infected with V. vulnificus and had chronic liver disease. There are no reports in Korea on the clinicopathological findings of V. vulnificus infection. Here, we present the case of a patient with V. vulnificus septicemia and describe the associated clinical symptoms and clinicopathological findings discovered upon autopsy.
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