Infectious disease took the leading cause of death in patients with systemic lupus erythematosus (SLE). Especially Salmonella infection occurs more common in SLE patients. We report a case of thyroid abscess caused by Salmonella Group D in a patient with SLE. A patient, 29-year-old female, with SLE was admitted with a painful swelling of the left neck and diarrhea. The painful swelling of neck was revealed as an abscess of the thyroid and Salmonella Group D was isolated from the aspirated material of the thyroid abscess. The patient recovered after surgical drainage and administration of intravenous 3rd cephalosporin.
Abscess* ; Adult ; Cause of Death ; Communicable Diseases ; Diarrhea ; Drainage ; Female ; Humans ; Lupus Erythematosus, Systemic* ; Neck ; Salmonella Infections ; Salmonella* ; Thyroid Gland*

BACKGROUND: The incidence of penicillin-resistant streptococcus pneumoniae(PRSP) accounts for almost 70% of all pneumococcal pneumonia cases in Korea. It is still unclear as to whether the efficacy of penicillin or equally active beta-lactam agents is compromised in PRSP pneumonia. This study investigated the prevalence of PRSP in community-acquired pneumonia and its clinical course. METHODS: A total of 42 patients with community-acquired pneumococcal pneumonia were evaluated from July 1999 to May 2001. The cultured strains of Streptococcus pneumoniae were divided into susceptible, intermediately resistant, and resistant strains by an E-test, and the effect of the clinical course was investigated. RESULTS: From a total of 42 patients, 22 (52.4%) patients had an intermediate resistance (MIC 0.1-1 microgram/ml) and six (14.3%) showed a high resistance (MIC> or =2.0 microgram/ml) with current penicillin susceptibility categories. However, according to the classification of the DRSPTWG (Drug Resistant Streptococcus pneumoniae Therapeutic Working Group), there were 11 cases (26.2%) of intermediate resistance and no case of high resistance. Under empirical antimicrobial treatment, there was no difference in the clinical outcome between the penicillin susceptible and resistant group. CONCLUSION: The clinical outcome of PRSP pneumonia with empirical therapy was acceptable. These results suggest that the current MIC breakpoint for penicillin resistance in Streptococcus pneumoniae has been set at a very low level and penicillin resistance according to the NCCLS classification does not significantly influence the outcome of the empirical treatment for pneumococcal pneumonia.
Classification ; Humans ; Incidence ; Korea ; Penicillin Resistance ; Penicillins ; Pneumonia ; Pneumonia, Pneumococcal* ; Prevalence* ; Prognosis ; Streptococcus ; Streptococcus pneumoniae

BACKGROUND: Tuberculin skin test is a method to examine M. tuberculosis infection and has been used all over the world. But various factors make it difficult to understand testing results. In 2000, the American Thoracic Society recommended that skin test results should be decided by considering risk factors of the tested. In Korea, high tuberculosis infection rate and BCG vaccination rate make it difficult to differentiate current infection, past infection, and no infection by the skin test. This study was attempted to examine a negative predictive value of the skin test to understand how the skin test acts on deciding administration of anti-tuberculosis drug. METHOD: From Mar. 1 to Jul. 31 in 2001, the test was performed for patients hospitalized in Department of Internal Medicine, Hallym University College of Medicine, Chunchon, Korea by administering Tuberculin PPD RT23 2 TU (0.1 ml)to them that has been currently used in Korea based on Mantoux method. They were decided to be infected with tuberculosis bacilli by following diagnostic standard: 1) tuberculosis bacilli was cultured in sputum by microbiological diagnostic standard or Acid-fast bacilli was proven on a microscopic examination or 2) tuberculosis bacilli was not proven in the aforesaid microbiological test by clinical diagnostic standard, while there was opinion or symptom suitable for tuberculosis by radiographic or histological standard so the doctor decided to apply the tuberculosis treatment. RESULTS: In this study, total 210 patients except 20 patients (8.7%) among 230 hospitalized patients were evaluated. Their average age was 60 16.8 years, and male-female rate was 1.28 : 1 (male: 118, female: 92). Number of patient, who was diagnosed and decided as tuberculosis, was 53(25.2%). Pulmonary tuberculosis was found in 45 patients (84.9%); 22 patients were decided to be positive in the Acid-fast bacilli smear test by microbiological examination (culture positive: 13, culture negative: 9), and 23 patients were decided to be tuberculosis patients by clinical diagnosis standard. Tuberculosis pleuritis was found in 8 patients (15.1%); 4 patients were diagnosed and decided by histological standard, and 4 patients were decided and treated by clinical standard. In differentiating patients into 'Negative' and 'Positive' by the skin test standard of the American Thoracic Society, negative predictive value 92.3%, positive predictive value 47.3%, sensitivity and specificity were 83%, 68.8%, respectively. CONCLUSION: In hospitalized respiratory patients, there was high negative predictive vlaue 92.3% by tuberculin skin test, therefore skin test would be a important factor for deciding administration of anti-tuberculosis drug on negative skin test patient.
Diagnosis ; Female ; Gangwon-do ; Humans ; Internal Medicine ; Korea ; Mycobacterium bovis ; Pleurisy ; Risk Factors ; Skin Tests* ; Skin* ; Sputum ; Tuberculin* ; Tuberculosis ; Tuberculosis, Pulmonary ; Vaccination