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면역 부전 환자에서 병발한 급성 황색 포도상 구균에 의한 세균성 식도염 1예
박환양,김춘관,박영배,박재완,김성훈,강정원,문경협,양수현,변종훈 대한감염학회 2001 감염 Vol.33 No.5
Bacterial esophagitis is an uncommon disease and has not been well characterized. Bacterial infection of the esophagus is usually presented as a superimposed infection upon a preexisting viral or fungal esophagitis and most patients are immunocompromised hosts. A 67-year-old man was admitted for retrosternal pain and hematemesis, who had a past history of long-standing diabetes mellitus and end stage renal disease, also had a history of steroid medication. Extensive esophageal ulcerations of the mucosa were visualized by endoscopy. Staphylococcus aureus grew in blood culture. After the 2 weeks of antibiotics treatment, he was successfully recovered without any sequelae. Due to its rarity, this case is herein reported with a review of the corresponding literature. (Korean J Infect Dis 33:360∼363, 2001)
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Vancomycin 내성 enterococci 패혈증에서 성공적인 고용량 ampicillin, imipenem, teicoplanin 병합치료 1예
김민정,박환양,마상수,박영배,이명희,김춘관,김봉석,노용호 대한화학요법학회 2001 대한화학요법학회지 Vol.19 No.3
저자들은 면역부전 환자에서 발생한 VRE 패혈증을 고용량의 ampicillin(30g/일), imipenem(2.0g/일)과 teicoplanin(400㎎/일)의 병합치료로 성공적으로 치유하여 이에 대한 증례를 보고하는 바이다. Vancomycin-resistant enterococcus (VRE) infection have become a threatening problem. VRE bacteremia, especially in immunosuppressed host, is difficult to treat and has high mortality rate, because few antimicrobial agents are available. To date, a few studies were reported about combination therapy for VRE infection in animal model. We had experienced a case of successfully treated VRE septicemia by combination of high dose ampicillin (30g/day), imipenern (2.0g/day) and teicoplanin (400㎎/day) in a neutropenic patient. A patient with acute myelogenous leukemia had developed fever after high dose chemotherapy. Physical examination showed no definite focus of clinical infection. But, he had a Hickmann catheter and his peripheral blood examination revealed neutropenia. Initially, although ceftazidime was administered for 3 days, fever was persistent and septic shock developed. Microbiologic study showed that VRE grew in his blood culture. The VRE were determined to E. faecium of Van A type and MIC of ampicillin was more than 16㎍/mL. Hickmann catheter was removed and high dose ampicillin, imipenem and teicoplanin were administered. After that, VRE bacteremia was cleared and the patient successfully recovered from septic shock.
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