4.The first imported case of pulmonary coccidioidomycosis in Korea.
Jaejung JANG ; Ho Jung LEE ; Inchul LEE ; Yong Kyun CHO ; Hyun Jo KIM ; Kwang Hyun SOHN
Journal of Korean Medical Science 1999;14(2):206-209
Coccidioidomycosis is an endemic disease found in the southwestern part of North America. Travellers who visit the endemic area may carry the infection. We report a case of pulmonary coccidioidomycosis in a 74-year-old woman. She was healthy before visiting Arizona, U.S.A twice. After returning home, she began to complain of intermittent dry coughing. The symptom was mild, however, and she was treated symptomatically. Later a chest radiograph, which was taken 4 years after the onset of the symptom, showed a solitary pulmonary nodule in the right upper lobe. By percutaneous needle aspiration, a few clusters of atypical cells were noted in the necrotic background. A right upper and middle lobectomy was done. A 1.5 x 1.5 x 1.2 cm sized tan nodule was present in otherwise normal lung parenchyma. Microscopically, the nodule consisted of aggregates of multiple solid granulomas inside of which was mostly necrotic. Neutrophils and nuclear debris were scattered along the periphery of the necrotic foci. Numerous multinucleated giant cells were associated with the granulomas. In the necrotic area, mature spherules of Coccidioides immitis, which were 30-100 microm in diameter, were present. They contained numerous endospores which ranged from 5 to 15 microm and were also noted in multinucleated giant cells. The diagnosis of coccidioidomycosis was made. She is doing well after the resection.
Aged
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Case Report
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Coccidioides*
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Coccidioidomycosis/pathology
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Coccidioidomycosis/microbiology*
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Female
;
Human
;
Korea
;
Lung Diseases, Fungal/pathology
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Lung Diseases, Fungal/microbiology*
5.Application of bacterial cultures of bronchoalveolar lavage fluids in children with pulmonary infection.
Gao-Ping ZHANG ; Qiang CHEN ; Jian-Mei LIU ; Shu-Ping ZHOU ; Xiao-Jun YU ; Juan LU ; Lan LI ; Xiao-Hua ZHU ; Ai-Min WU ; Jian LI ; Ci-Lang HU ; Yun DU ; Li LI
Chinese Journal of Contemporary Pediatrics 2012;14(5):350-352
OBJECTIVETo study the value of bacterial cultures of bronchoalveolar lavage fluids (BALF) in children with pulmonary infection.
METHODSBacterial cultures sampled from both sputum and BALF were performed on 80 hospitalized children with pulmonary infection between June 2008 and February 2011.Culture results between the two samples were compared.
RESULTSIn the 80 children with pulmonary infection, bacterial cultures of BALF showed that Viridans Streptococci were found in 72 cases (90%), Neisseria in 41 cases (51%), Streptococcus pneumoniae in 11 cases (14%), Staphylococcus Aureus in 3 cases (4%) and Escherichia coli in 3 cases (4%). The positive rates of Viridans Streptococci in the bacterial cultures of BALF was not significantly different from the bacterial cultures of sputum, but the positive rate of Streptococcus pneumoniae in the bacterial cultures of BALF was significantly higher than in the bacterial cultures of sputum (4%). Moreover, Escherichia coli were found only by bacterial cultures of BALF.
CONCLUSIONSBacterial cultures of BALF are useful in the identification of pathogenic bacteria for pulmonary infection in children. Due to the samples taken from the lesion regions in bacterial cultures of BALF, the results of may be more reliable.
Bacteria ; isolation & purification ; Bacterial Infections ; microbiology ; Bronchoalveolar Lavage Fluid ; microbiology ; Child, Preschool ; Female ; Humans ; Infant ; Lung Diseases ; microbiology ; Male
6.A Case of Pulmonary Cryptococcosis by Capsule-deficient Cryptococcus neoformans.
Won Seok CHEON ; Kwang Seok EOM ; Byoung Kwan YOO ; Seung Hun JANG ; Joon Woo BAHN ; Dong Gyu KIM ; Ki Suck JUNG
The Korean Journal of Internal Medicine 2006;21(1):83-87
Pulmonary infection by capsule-deficient Cryptococcus neoformans (CDCN) is a very rare form of pneumonia and it is seldom seen in the immunocompetent host. The authors experienced a case of pulmonary cryptococcosis by CDCN in 25-year-old woman who was without any significant underlying disease. The diagnosis was made from the percutaneous lung biopsy and special tissue staining, including Fontana-Masson silver (FMS) staining. Fungal culture confirmed the diagnosis afterward. Her clinical and radiologic features improved under treatment with fluconazol. It's known that CDCN is not so readily confirmed because fungal culture does not always result in growth of the organism and the empirical fungal stain is not helpful for the differentiation between CDCN and the other infections that are caused by the nonencapsulated yeast-like organisms. In this report, we emphasize the diagnostic value of performing FMS staining for differentiating a CDCN infection from the other confusing nonencapsulated yeast-like organisms.
Silver Nitrate
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Lung Diseases/*diagnosis/*microbiology
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Humans
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Female
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Cryptococcus neoformans/*isolation & purification
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Cryptococcosis/*diagnosis/microbiology
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Cough
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Chest Pain
;
Adult
10.Sequential Bilateral Lung Resection in a Patient with Mycobacterium Abscessus Lung Disease Refractory to Medical Treatment.
Seung Heon LEE ; Joo Won MIN ; Sang Won UM ; Seon Sook HAN ; Sung Koo HAN ; Young Soo SHIM ; Jae Joon YIM
Yonsei Medical Journal 2010;51(1):141-144
Mycobacterium abscessus (M. abscessus) is the second most common nontuberculous mycobacteria (NTM) in South Korea. Nevertheless, the diagnosis and treatment of M. abscessus lung disease can be problematic. Surgical resection has been tried for patients with localized M. abscessus lung disease refractory to medical treatment. Here, we report on a 25-year-old woman with M. abscessus lung disease who had been diagnosed and treated three times for pulmonary tuberculosis. She was initially diagnosed as having M. intracellulare lung disease; however, M. abscessus was isolated after several months of medication. She had multiple bronchiectatic and cavitary lesions bilaterally, and M. abscessus was repeatedly isolated from her sputa despite prolonged treatment with clarithromycin, ethambutol, moxifloxacin, and amikacin. She improved only after sequential bilateral lung resection. Based on the experience with this patient, we suggest that, if medical treatment fails, surgical resection of a diseased lung should be considered even in patients with bilateral lesions.
Adult
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Anti-Bacterial Agents/pharmacology/*therapeutic use
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Female
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Humans
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Lung Diseases/*drug therapy/*microbiology/surgery
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Mycobacteria, Atypical/drug effects/*physiology