폐암 환자에서 발생한 원발성 피부 Nocardia 감염증 1예
A case of primary cutaneous nocardiosis in a patient with lung cancer
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초록
Nocardia 감염증은 건강한 사람에서는 매우 드물지만 스테로이드나 면역억제제를 사용하는 경우처럼 면역기능이 저하된 환자들에서 발생하는 기회감염이 점차 증가하고 있다. 호흡기를 통해 인체에 감염되는 경우가 많으나 드물게 피부를 통하여 감염되기도 한다. 저자들은 폐암으로 방사선 치료 후 스테로이드를 투여 중이던 환자에서 발생한 족부의 원발성 피부 Nocardia 감염증 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
Nocardiosis is a rare opportunistic bacterial infection. The majority of nocardial infections are acquired through inhalation and smaller numbers of cutaneous nocardiosis are caused by traumatic inoculation of organisms percutaneously. We experienced a patient with lung cancer that developed a primary cutaneous nocardiosis. A 57-year-old man was admitted to the Samsung Medical Center because of a painful swelling lesion of the right foot that developed 3 weeks prior. Three months prior, the patient had been diagnosed with a non-small cell lung cancer, and then underwent palliative bronchial stent insertion, radiation therapy and corticosteroid treatment for an obstructive endobronchial lesion. Incision and drainage was performed as magnetic resonance imaging (MRI) of the foot showed an abscess cavity. Nocardia was isolated from the pus. The antibiotic therapy was changed to oral trimethoprim/ sulfamethoxazole (TMP/SMX) treatment. The skin lesion was improving and the patient was discharged 20 days later. TMP/SMX was continued for a total of three months. The patient has been in good health and the skin lesion had completely healed two months after discharge.(Korean J Med 73:342-345, 2007)
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