CAPD 환자에서 도관 균락화와 합병된 Penicillium marneffei 복막염 1 예

• Published in: Kidney research and clinical practice Vol. 21; no. 4; pp. 680 - 685
• Main Authors: 강신욱, Shin Wook Kang, 한대석, Dae Suk Han, 이호영, Ho Yung Lee, 한상훈, Sang Hoon Han, 최훈영, Hoon Young Choi, 이상철, Sang Cheol Lee, 구영석, Young Suck Goo, 장경희, Kyung Hee Chang, 김준명, June Myung Kim, 용동은, Dong Eun Young, 이경원, Kyung Woon Lee, 신종희
• Format: Journal Article
• Language: Korean
• Published: 대한신장학회 01.07.2002
• ISSN: 2211-9132

P. marneffei is a fungus that causes life-threatening disseminated infection in a geographically distinct areas of the world. Following the first case of human infection in 1959, the incidence of this infection has risen markedly during the past 5 years. However, even in the midst of such rapid increase, the infection has always occurred only in a limited geographic distributions or in persons who have visited this limited geographic areas. These areas include Myanmar, Hong Kong, Indonesia, Laos, Malaysia, Singapore, Taiwan, Thailand, Vietnam, and the Guangxi province of southern China. P. marneffei infection occurs mostly in immunocompromised patients, particularly AIDS patients. P. marneffei infection commonly presents with skin and subcutanous tissue infection, fungemia, diarrhea, bone marrow infection, and generalized lymphadenopathy with hepatosplenomegaly. We report the case of continuous ambulatory peritoneal dialysis-associated peritonitis caused by P. marneffei. The case occurred in Korea, a non-endemic area of P. marneffei, in a non-AIDS patient who has not been exposed to any of the endemic areas. This warrants further consideration in determining the yet unknown transmission route of this fungal organism. P. marneffei was diagnosed without delay by 18sRNA PCR and sequencing, and was later confirmed by culture. PCR and sequencing may contribute to the early diagnosis of the P. marneffei infection, which is important given this infection`s ability to progress to a systemic infection with high mortality rate when diagnosis and management are delayed.