뇌성마비 소아에서 진단된 폐결핵에 병발된 결핵성 장염 1례
A Case of Intestinal Tuberculosis Complicated with Pulmonary Tuberculosis in a Young Adolescent with Cerebral Palsy
최성윤, 김영민, 배선환,
소속 상세정보
최성윤 ( Choi Sung-Yun )
을지대학교 의과대학 소아과학교실
김영민 ( Kim Young-Min )
을지대학교 의과대학 소아과학교실
배선환 ( Bae Sun-Hwan )
을지대학교 의과대학 소아과학교실
KMID : 0816120040070010102
Abstract
저자들은 객담을 뱉지 못하는 뇌성마비 환아에서 객담 검사와 방사선학적 검사, 대장 조영술과 복부전산화단층촬영 검사를 통해, 폐결핵에 동반되어 상행 결장을 침범한 장결핵을 진단하고 항결핵제를 투여하여 임상적 호전을 가져온 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.
About 20% of intestinal tuberculosis have active pulmonary tuberculosis. Intestinal tuberculosis can develop by swallowing sputum which have active pulmonary tuberculosis and by ingestion of contagious milk. We report a case of intestinal tuberculosis complicated with pulmonary tuberculosis in a 15-year old adolescent who could not cough out sputum because of known cerebral palsy. He was admitted because of 3 day history of fever and bloody stool. Chest PA showed both upper lobe consolidation. AFB stain and AFB PCR was positive for tuberculosis. Colon study showed abscence of haustral marking and lead pipe appearance due to stenosis of ascending colon and mucosal edema. Abdominal CT scan showed mild wall thickening in ascending colon. Despite the anti-tuberculosis therapy with first line drugs, fever accompanying pleural effusion developed. Second line drug with Isoniazid and Rifampin improved clinical manifestation. After the report on sensitivity, we readjusted the regimen, and clinical manifestations improved gradually.
키워드
Intestinal Tuberculosis;Pulmonary Tuberculosis;Cerebral Palsy;Adolescent
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