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A Case of Invasive Aspergillosis Characterized by the Formation of Large Bronchial Cast in Patient with Acute Myelogenous Leukemia
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Çöµ¿¿ì/Dong Woo Hyun
±èµ¿È¯/Á¤ÁøÅÂ/¼Õ»ó±Õ/À̱Ժ¸/Dong Hwan Kim/Jin Tae Jung/Sang Kyun Sohn/Kyu Bo Lee
KMID : 0360319980300051021
Abstract
¼·Ð
ħ½À¼º ¾Æ½ºÆ丣±æ·ç½ºÁõ(invasive aspergillosis)Àº ¸é¿ª±â´ÉÀúÇÏ È¯ÀÚ¿¡¼ ¹ß»ýÇÏ´Â °¨¿°
ÁõÀ¸·Î, ÃÖ±Ù Àå±âÀ̽ļú ¹× ¾Ç¼ºÁ¾¾ç¿¡ ´ëÇÑ °í¿ë·® Ç×¾ÏÈÇпä¹ýÀÌ ½ÃÇàµÊ¿¡ µû¶ó ºóµµ°¡
Áõ°¡ÇÏ°í ÀÖ´Ù. ¹ßº´ ÀÎÀڷδ Áö¼ÓÀû ÀΠȣÁß±¸°¨¼ÒÁõ, ¸é¿ª¾ïÁ¦Á¦ÀÇ »ç¿ë, ¼÷ÁÖÀÇ ¸é¿ª±â
´ÉÀúÇÏ, ±¤¹üÀ§ Ç×»ýÁ¦ÀÇ »ç¿ë µîÀÌ ÀÖÀ¸¸ç, ±× Áß Áö¼ÓÀûÀΠȣÁß±¸°¨¼ÒÁõÀÌ °¡Àå Áß¿äÇÑ ÀÎ
ÀÚ·Î ¾Ë·ÁÁ® ÀÖ´Ù. ±â°üÁö ¿øÁÖ(bronchial cast)´Â ±â°üÁö³» ºÐºñ¹°ÀÇ Áõ°¡ ¹× ¹èÃâÀå¾Ö¸¦ °¡
Áø Æó Áúȯ¿¡ ÈçÈ÷ µ¿¹ÝµÇ¸ç, ¿øÀÎÁúȯÀ¸·Î´Â Æó·Å, ±â°üÁöÈ®ÀåÁõ, ¸¸¼º ±â°üÁö¿°, ¾Ë·¯Áö ±â
°üÁöÆó ¾Æ½ºÆ丣±æ·ç½ºÁõ, Á¡¾×¼ºÁ¡ÂøÁõ(mucoviscidosis) µîÀÌ ¾Ë·ÁÁ® ÀÖ´Ù. ±¹³»¿¡¼ ±â°ü
Áö ¿øÁÖ¸¦ Çü¼ºÇÑ Ä§½À¼º ¾Æ½ºÆ丣±æ·ç½ºÁõÀº º¸°íµÈ ¹Ù°¡ ¾øÀ¸¸ç, ƯÈ÷ ħ½À¼º ¾Æ½ºÆ丣±æ
·ç½ºÁõÀÌ ÁÖ·Î ±Þ¼º ¹éÇ÷º´ ȯÀÚ¿¡¼ Ç×¾ÏÈÇпä¹ý ÈÄ È£Áß±¸°¨¼ÒÁõ »óÅ¿¡¼ ÈçÈ÷ ¹ßº´ÇÏ
°í, È£Áß±¸°¨¼ÒÁõÀ¸·Î ÀÎÇÑ ¿°Áõ¹ÝÀÀÀÌ ¹Ì¾àÇϱ⠶§¹®¿¡ ±â°üÁö ¿øÁÖ¸¦ Çü¼ºÇÑ ¿¹´Â ±ØÈ÷
µå¹® °ÍÀ¸·Î »ý°¢µÈ´Ù. ÀúÀÚµéÀº ±Þ¼º °ñ¼ö¼º ¹éÇ÷º´ ȯÀÚ¿¡¼ Ç×¾ÏÈÇпä¹ý ½Ç½Ã µµÁß °Å
´ë ±â°üÁö ¿øÁÖ¸¦ Çü¼ºÇÑ Ä§½À¼º ¾Æ½ºÆ丣±æ·ç½ºÁõÀ» °æÇèÇÏ¿´±â¿¡ ¹®Çå °íÂû°ú ÇÔ²² º¸°í
ÇÏ´Â ¹ÙÀÌ´Ù.
Invasive aspergillosis is a life-threatening infectious disease in immunocompromised
patients. Prolonged neutropenia is the most important predisposing factor. Bronchial casts
are generally associated with pneumonia, bronchiectasis, asthma, chronic bronchitis,
allergic bronchopulmonary aspergillosis and mucoviscidosis. We experienced. a case of
invasive aspergillosis characterized by the formation of large bronchial cast in patient
with acute myelogenous leukemia(AML) during induction chemotherapy The patient
expectorated a large bronchial cast without airway obstruction. Aspergillus was disclosed
in intraluminal surface of bronchial cast. The patient's conditions improved after
amphotericin B therapy and expectoration of a large bronchial cast.
Å°¿öµå
Invasive aspergillosis; Bronchial cast;
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