호중구감소증 환자에서의 기관-기관지아스페르길루스증 1예 = A Case of Fatal Tracheobronchial Aspergillosis in a Neutropenic Patient

다국어 초록 (Multilingual Abstract)

Tracheobronchial aspergillosis is an uncommon clinical form of invasive aspergillosis, particularly found in patients with AIDS and in lung transplant recipients than in other immunocompromised patients. The rapidity of the disease progression can result in fatal airway obstruction in a short period of time that the patient may need emergency tracheostomy without knowing the cause of the obstruction. We describe a case of fatal tracheobronchial aspergillosis which developed in a 43- year-old female patient with acute lymphoblastic leukemia. Dyspnea and stridor developed on the 20th day after 2nd consolidation chemotherapy, which was during the prolonged neutropenic period. Airway narrowing was observed on the computed tomograph scan of neck and emergency tracheostomy was performed. Infiltration with aspergillus hyphae was found in the tracheal ring and bronchial mucosa. Despite the use of amphotericin B, the patient died of bleeding and airway obstruction.

국문 초록 (Abstract)

저자들은 급성 림프구성 백혈병 환자에서 항암치료 후 호중구감소증이 지속되는 상태에서 침습성 아스페르길루스증의 드문 형태인 치명적인 아스페르길루스 기관기관지염을 경험하고 문헌고찰과 함께 증례를 보고하는 바이다.

참고문헌 (Reference)

1 "침습성 국균증의 진단과 경과 관찰을 위한 NASBA의 평가:예비보고" 35 : 99-106, 2003

2 "기관-기관지 아스페르길루스증 - 1 부검예 보고" 33 : 62-623, 1999

3 "급성 골수성 백혈병 환자에서 거대 기관지 원주를 형성한 침습성 아스페르길루스증 1예." 30 : 1021-1025, 1998

4 "Ulcerative trecheobronchitis after lung transplantation" 144 : 552-556, 1991

5 "Prolonged garnulocytopenia:the major risk factor for invasive pulmonary aspergillosis with acute leukemia" 100 : 345-351, 1984

6 "Nodular invasive tracheobronchitis due to Aspergillus in patient with systemic lupus erythematousus" 11 : 325-328, 2002

7 "Invasive pulmonary asperigillosis" 8 : 195-200, 2002

8 "Invasive Aspergillosis" 26 : 781-805, 1998

9 "Fungal tracheobronchitis. Report of 9 cases and Review of the Literature" 70 : 1-13, 1991

10 "Asperigillus 기관-기관지염 1예" 49 : 508-513, 2000

11 "Aspergillus tracheobronchitis after allogenic bone marrow transplantation." 26 : 1131-1132, 2000

12 "Aspergillus taccheobronchitis after allogenic bone marrow transplantation" 24 : 1145-1149, 1999

13 "Aspergillus species, Principles and practice of infectious disease" Churchill Livingstone 2674-2685, 2000

14 "Aspergillosis case- fatality rate:systemic review of the literature" 32 : 358-366, 2001

15 "Acute airway obstruction due to necrotizing tracheobronchial asperigillosis in immunocompromised patients:a new clinical entity" 98 : 718-720, 1989

16 "Acute airway obstruction and necrotizing tracheobronchitis from invasive mycosis" 106 : 1265-1267, 1994