Achromobacter Xylosoxidans에 의한 만성눈물주머니염 1예
A Case of Chronic Dacryocystitis Caused by Achromobacter Xylosoxidans
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목적: 만성 눈물주머니염으로 내원한 환자에서 Achromobacter xylosoxidans가 원인균으로 검출되어 이를 보고하고자 한다. 증례요약: 73세 여자환자가 안약 및 경구 항생제에 반응이 없어 본원으로 전원되었다. 눈물주머니 압박 시 배출되는 화농성 분비물로시행한 배양검사에서 Achromobacter xylosoxidans가 동정되었으며, 항생제 감수성 결과에 따라 tazocin 4.5 g/20 ml (piperacillin 2 g/tazobactam 0.25 g)을 정맥으로 하루 3번 투여하고 ceftazidime (50 mg/ml) 안약을 4시간 간격으로 사용하였다. 항생제를 교체한이후 병변은 호전되었고 피부경유 눈물주머니코안연결술을 시행하였으며, 현재 완치 상태로 경과관찰 중이다. 결론: Achromobacter xylosoxidans에 의한 눈물주머니 감염은 문헌으로 보고된 적이 없었으나 본 증례를 통해 눈물주머니염을 유발하는 원인균으로서의 가능성을 확인하게 되었으며, 배양검사 및 항생제 감수성 검사의 중요성을 보여준 예로 생각한다.
Abstract
Purpose: To report a case of chronic dacryocystitis caused by Achromobacter xylosoxidans. Case summary: A 73-year-old female was referred to our clinic for management of chronic dacryosyctitis from which she did not to recover despite empirical therapy. A. xylosoxidans was isolated from purulent discharge. Based on the results of susceptibility testing, therapy was changed to fortified ceftazidime eye-drop 6 times a day and intravenous tazocin 4.5 g/20ml (piperacillin 2 g/tazobactam 0.25 g) 3 times a day. All symptoms were resolved after treatment with sensitive antibiotics and external dacryocystorhinostomy. Conclusions: To our knowledge, this is the first report of A. xylosoxidans dacryocystitis. A. xylosoxidans are rare but potential pathogens which cause dacryocystitis. The cultures and sensitivity test were collected and processed to detect the presence of unusual pathogens in a case with persistent infection despite conventional treatment.
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