즐례 : 재발한 Churg-Strauss 증후군 치료 중 발생한 폐농양 1예

• Published in: The Korean journal of medicine Vol. 86; no. 1; pp. 106 - 109
• Main Authors: 이세옥, Se Ok Lee, 최규, Kyu Choi, 김정희, Jung Hee Kim, 김효진, Hyo Jin Kim, 장은영, Eun Young Jang, 이병재, Byung Jae Lee, 최동철, Dong Chull Choi
• Format: Journal Article
• Language: Korean
• Published: 대한내과학회 01.01.2014
• Subjects: Churg-Strauss syndrome; Churg-Strauss 증후군; Lung abscess; 폐농양
• ISSN: 1738-9364

저자들은 오랜 기간 관해 상태를 유지하던 중 재발한 Chrug- Strauss 증후군 환자에서 시클로포스파마이드 및 경구용 스테로이드 치료 중 발생한 폐농양 1예를 경험하였다. 본 증례 는 장기간의 관해 후에도 Churg-Strauss 증후군이 재발할 수 있고 치료 중 감염이 발생하였을 때 폐포자충폐렴이나 거대 세포 바이러스 감염과 같은 기회감염 이외에 세균 감염도 발생할 수 있음을 보여주는 증례이기에 문헌고찰과 함께 보 고하는 바이다. Churg-Strauss syndrome (CSS) is a rare disease characterized by asthma, peripheral eosinophilia and vasculitis. A quarter of CSS patients with clinical remission have experienced a relapse. We report here a case of lung abscess in a patient with relapsed CSS. A 46-year-old man who achieved clinical remission of CSS was confirmed for relapse by the presence of peripheral eosinophillia, pulmonary lesions and perivascular infiltrate of eosinophils in colon pathology. After administration of systemic glucocorticoid and one cycle of cyclophosphamide pulse therapy, he complained of dyspnea, sputum and chest pain. There were necrotic masses containing internal air-fluid levels in the right upper and the left lower lobes of the lung on chest radiography. Percutaneous needle aspiration culture specimens revealed the presence of K. pneumoniae. The patient was successfully treated with a 5-week course of antibiotics. (Korean J Med 2014;86:106-109)