Journal of Yeungnam Medical Science

Case reports

Gastric cancer and adenomatous colorectal polyp concomitant with pyogenic liver abscess and bacteremia: Min Kyu Kang, Hee Jung Kwon, Min Cheol Kim; Yeungnam Univ J Med. 2020;37(3):246-249. Published online April 10, 2020; DOI: https://doi.org/10.12701/yujm.2020.00094

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Abstract PDF: Synchronous gastric cancer and adenomatous colorectal polyp in patients with Klebsiella pneumoniae-induced pyogenic liver abscess (KP-PLA) and bacteremia is a rare presentation. A 58-year-old man with a 6-month history of diabetes mellitus (DM) presented with febrile sensation and dull abdominal pain in the right upper quadrant of the abdomen. Subsequent to laboratory test results and abdominal computed tomography findings, KP-PLA with bacteremia was diagnosed. After intravenous antibiotic administration, his symptoms improved, and upper endoscopy and colonoscopy were performed to evaluate the cause of KP-PLA. Biopsy specimens of the prepyloric anterior wall revealed a moderately differentiated adenocarcinoma. Endoscopic mucosal resection of the colon revealed high-grade dysplasia. Early gastric cancer (EGC) and adenomatous colorectal polyps with high-grade dysplasia concomitant with KP-PLA and bacteremia were diagnosed in our patient who had DM. Intravenous antibiotic treatment for KP-PLA, subtotal gastrectomy for EGC, and colonoscopic mucosal resection for the colon polyp were performed. After 25 days of hospitalization, subtotal gastrectomy with adjacent lymph node dissection was performed. Follow-up ultrasound imaging showed resolution of the abscess 5 weeks post-antibiotic treatment, as well as no tumor metastasis. Upper gastrointestinal endoscopy and colonoscopy should be performed to evaluate gastric cancer in patients with PLA or bacteremia, accompanied with DM or an immunocompromised condition.

Community-acquired Achromobacter xylosoxidans infection presenting as a cavitary lung disease in an immunocompetent patient: Chan Hee Hwang, Woo Jin Kim, Hye Young Jwa, Sung Heon Song; Yeungnam Univ J Med. 2020;37(1):54-58. Published online August 12, 2019; DOI: https://doi.org/10.12701/yujm.2019.00276

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Achromobacter xylosoxidans is a gram-negative bacterium that can oxidize xylose. It is commonly found in contaminated soil and water but does not normally infect immunocompetent humans. We report a case of a cavitary lung lesion associated with community-acquired A. xylosoxidans infection, which mimicked pulmonary tuberculosis or lung cancer in an immunocompetent man. The patient was hospitalized due to hemoptysis, and chest computed tomography (CT) revealed a cavitary lesion in the superior segment of the left lower lobe. We performed bronchoscopy and bronchial washing, and subsequent bacterial cultures excluded pulmonary tuberculosis and identified A. xylosoxidans. We performed antibiotic sensitivity testing and treated the patient with a 6-week course of amoxicillin/clavulanate. After 2 months, follow-up chest CT revealed complete resolution of the cavitary lesion.

Citations

Citations to this article as recorded by

Achromobacter species (sp.) outbreak caused by hospital equipment containing contaminated water: risk factors for infection
J. Tian, T. Zhao, R. Tu, B. Zhang, Y. Huang, Z. Shen, G. Du, Y. Wang
Journal of Hospital Infection.2024; 146: 141. CrossRef
Full characterization of plasmids from Achromobacter ruhlandii isolates recovered from a single patient with cystic fibrosis (CF)
Carla Steffanowski, Mariana Papalia, Andrés Iriarte, Mauricio Langleib, Laura Galanternik, Gabriel Gutkind, Vaughn Cooper, María Soledad Ramírez, Marcela Radice
Revista Argentina de Microbiología.2022; 54(1): 3. CrossRef
Nosocomial Achromobacter xylosoxidans Infection Presenting as a Cavitary Lung Lesion in a Lung Cancer Patient
Vinoja Sebanayagam, Paul Nguyen, Mo'ath Nassar, Ayman Soubani
Cureus.2020;[Epub] CrossRef

Original Articles

Clinical characteristics of acute lower respiratory tract infections according to respiratory viruses in hospitalized children without underlying disease during the last 3 years: Min Hae Seo, Hyung Young Kim, Tae Min Um, Hye Young Kim, Hee Ju Park; Yeungnam Univ J Med. 2017;34(2):182-190. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.182

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Abstract PDF: BACKGROUND
Respiratory viruses play a significant role in the etiology of acute respiratory infections and exacerbation of chronic respiratory illnesses. This study was conducted to identify the epidemiological and clinical characteristics of children with acute viral lower respiratory infections. METHODS: This study investigated 1,168 children diagnosed with acute viral lower respiratory tract infections (RTIs) between January 2012 and December 2014. Specimens of respiratory viruses were collected using a nasopharyngeal swab and analyzed by reverse transcriptase polymerase chain reaction. We retrospectively reviewed the medical records and analyzed the clinical features of children hospitalized for acute lower respiratory infections. RESULTS: Respiratory syncytial virus (RSV), the main cause of infection in children aged <5 years, was the most commonly detected pathogen in children with bronchiolitis and pneumonia, and resulted in high proportions of children requiring oxygen treatment and intensive care unit admission. Rhinovirus was preceded by RSV as the second most common cause of bronchiolitis and pneumonia, and was detected most frequently in the children aged ≥6 years. In addition, asthma was predominantly caused by rhinovirus in children aged ≥6 years, whereas croup was mostly caused by parainfluenza virus in those aged <5 years. Rhinovirus infection (p < 0.001) and history of asthma (p=0.049) were identified as significant risk factors for readmission within a month. CONCLUSION: We identified the epidemiological and clinical characteristics of respiratory viruses in children with acute lower respiratory infections during the last 3 years. Our findings may provide useful clinical insight to comprehend the acute viral lower RTIs in children.

Clinical features according to chest radiologic patterns of Mycoplasma pneumonia in children.: Young Hyun Kim, Jin Hyeon Kim, Sae Yoon Kim, Young Hwan Lee; Yeungnam Univ J Med. 2016;33(2):98-104. Published online December 31, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.2.98

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Abstract PDF: BACKGROUND
Clinical differences in Mycoplasma pneumonia (MP) in children and adolescent patients according to abnormal infiltrate patterns on the chest X-ray were compared. METHODS: From 2012 to 2015, patients (n=336) diagnosed with MP at Yeungnam University Medical Center have been classified as eiher lobar pneumonia or bronchopneumonia based on the infilterate patterns observed on chest X-ray. Cases were analyzed retrospectively for gender, age, seasonal incidence rate, main symptoms (fever duration, extrapulmonary symptoms), and laboratory results, including white blood cell count, hemoglobin, platelets, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), as well as concurrent respiratory virus infection. RESULTS: The following results were observed. First, lobar pneumonia affected 22.0% of all MP patients and was the most common in preschool children, with a high incidence rate in November and December. Second, lobar pneumonia had a longer fever duration than bronchopneumonia (p<0.001), and also showed significantly higher platelets (336.8 vs. 299.1 k/µL, p=0.026), ESR(46.3 vs. 26.0mm/hr, p<0.001) and CRP (4.86 vs. 2.18mg/dL, p=0.001). Third, viral co-infection was more common in bronchopneumonia (p=0.017), affecting 66.7% of infants and toddlers (p=0.034). Finaly, lobar consolidation was most common in both lower lobes. CONCLUSION: MP in children has increased in younger age groups, and the rate of lobar pneumonia with severe clinical symptoms is higher in older children.

Case Reports

Lymphocytic interstitial pneumonia in a patient with Sjögren's syndrome.: Eun Hye Lee, Ji Eun Park, Eun Kyong Goag, Young Joo Kim, In Young Jung, Chi Young Kim, Young Mok Park, Jung Mo Lee, Moo Suk Park; Yeungnam Univ J Med. 2016;33(2):112-115. Published online December 31, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.2.112

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Abstract PDF: Lymphocytic interstitial pneumonia (LIP) is a rare benign lymphoproliferative disorder characterized by diffuse infiltration of the pulmonary parenchymal interstitium by polyclonal lymphocytes and plasma cells. LIP has been associated with a variety of clinical conditions; such as connective tissue disorders and other immune system abnormalities. Treatment usually involves administration of corticosteroids and other immunosuppressants. We report on a 38-year-old female patient who complained of shortness of breath, dry mouth, and dry eyes for more than 1 month, and was positive for Raynaud's phenomenon. Based on surgical biopsy, she was diagnosed as having LIP accompanied by Sjögren's syndrome. The patient was treated with high-dose steroids followed by maintenance therapy for approximately 2 years, and her condition improved.

Lipiodol-induced pneumonitis following transarterial chemoembolization for ruptured hepatocellular carcinoma.: Haewon Kim, Yong Hoon Kim, Hong Jin Yoon, Kwang Hoon Lee, Seung Moon Joo, Min Kwang Byun, Jung Il Lee, Kwan Sik Lee, Ja Kyung Kim; Yeungnam Univ J Med. 2014;31(2):117-121. Published online December 31, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.2.117

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Abstract PDF

Transarterial chemoembolization (TACE) is a widely accepted nonsurgical modality used for the treatment of multinodular hepatocellular carcinoma (HCC). The careful selection of the candidate is important due to the risk of developing various side effects. Fever, nausea, abdominal pain, and liver enzyme elevation are commonly known side effects of TACE. Hepatic failure, ischemic cholecystitis, and cerebral embolism are also reported, although their incidence might be low. Pulmonary complication after TACE is rare, and the reported cases of lipiodol pneumonitis are even rarer. A 53-year-old man was treated with TACE for ruptured HCC associated with hepatitis B virus infection. On day 19 after the procedure, the patient complained of dyspnea and dry cough. Chest computed tomography showed diffuse ground glass opacities in the wholelung fields, suggesting lipiodol-induced pneumonitis. After 2 weeks of conservative management, the clinical symptoms and radiologic abnormalities improved. Reported herein is the aforementioned case of lipiodol-induced pnemonitis after TACE, with literature review.

Citations

Citations to this article as recorded by

Lipiodol Pneumonitis Following Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma
Sungkeun Kim, Hee Yeon Kim, Su Lim Lee, Young Mi Ku, Yoo Dong Won, Chang Wook Kim
Journal of Liver Cancer.2020; 20(1): 60. CrossRef
Secondary adrenal insufficiency caused by sorafenib administration in a patient with hepatocellular carcinoma
Soo Yeon Jo, Soo Hyung Ryu, Mi Young Kim, Jeong Seop Moon, Won Jae Yoon, Jin Nam Kim
Yeungnam University Journal of Medicine.2016; 33(2): 155. CrossRef

A Case of Severe Enterovirus Pneumonia in an Immunocompetent Adult.: Dong Won Lee, Eun Young Choi; Yeungnam Univ J Med. 2013;30(1):58-61. Published online June 30, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.1.58

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Abstract PDF: Enterovirus commonly causes neurologic diseases (aseptic meningitis, encephalitis, etc.), hand-foot-mouth disease, herpangina, and acute hemorrhagic conjunctivitis. However, it rarely causes pneumonia in immunocompetent adults. In Korea, no case has been reported about pneumonia caused by enterovirus in healthy adults. We can cite the case of a 20-year-old woman who presented severe community-acquired pneumonia caused by enterovirus. The diagnosis was based on reverse transcriptase polymerase chain reaction (RT-PCR) of a respiratory specimen.

Original Article

Presumptive Diagnosis of Mycoplasma pneumoniae Pneumonia in Children.: Chang Eon Lee, Su Jin Park, Won Duck Kim; Yeungnam Univ J Med. 2012;29(2):89-95. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.89

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Abstract PDF: BACKGROUND
As Mycoplasma pneumoniae pneumonia has increased in Korea, its relevance to infants, toddlers, and adolescents has magnified as well as. However, it is difficult to perform the serological test and PCR test routinely for diagnosis in actual clinical practice. Thus, the authors conducted this study to help clinicians do presumptive diagnosis of Mycoplasma pneumoniae pneumonia using clinical, radiological, and hematological findings. METHODS: The study population consisted of 224 children between 1 month and 14 years old, hospitalized for radiographically confirmed pneumonia. Patients were divided into two groups of 100 children with Mycoplasma pneumoniae pneumonia, as diagnosed using the ELISA method. Groups with negative result in Mycoplasma IgM antibody test were classified into the viral group (98 patients with respiratory virus) and the bacterial group (46 patients with the bacteria detected in the blood sputum culture or antibiotic treatment except macrolide improved the patient's condition). These groups were compared and analyzed using clinical, hematological,and radiographic differences and scoring system. RESULTS: Clinical, hematological, and radiographic characteristics of Mycoplasma pneumoniae pneumonia have shown the intermediate level results between bacterial pneumonia and viral pneumonia. In terms of scoring system, the mean score of Mycoplasma pneumoniae pneumonia was 4.23, which was the intermediate level between bacterial pneumonia (mean score=6.67) and viral pneumonia (mean score=1.48). CONCLUSION: Results suggest that the combination of the scoring system information can increase the accuracy in the diagnosis even if they may have difficulties on diagnosis, because clinical manifestations, hematological, and radiographic findings are nonspecific.

Review

Clinical Implications of Drug-Resistant Streptococcus pneumoniae as a Cause of Community Acquired Pneumonia.: Kyeong Cheol Shin; Yeungnam Univ J Med. 2011;28(1):13-19. Published online June 30, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.1.13

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Abstract PDF: The emergence of antibiotic-resistant pathogens is a serious clinical problem in the treatment of infectious diseases that increase mortality, morbidity, hospitalization length, and the cost of healthcare. In particular, Streptococcus pneumoniae is a major etiologic pathogen of pneumonia, sinusitis, otitis media, and meningitis. As the definition of penicillin resistance to S. pneumoniae was recently changed, macrolide-resistant S. pneumoniae is a major resistant pathogen in the community. Infections caused by antibiotic-resistant strains are associated with incorrect use of antibiotics and critical clinical outcomes. For the appropriate use of antibiotics to treat infections, physicians always should have up-to-date information on the current epidemiologic status of antibiotic resistance for common pathogens and their susceptibility to antimicrobials. Appropriate selection of antimicrobials, strict control of infection, vaccination, and development of a feasible national policy of infection control are important strategies for the control of antimicrobial resistance. This review article focuses on the current status of antibiotic-resistant S. pneumoniae in community-acquired pneumonia in Korea.

Case Reports

A Case of Dermatomyositis with Secondary Organizing Pneumonia.: Chul Yun Park, Jung Seok Chung, Jin Wook Chung, Choong Ki Lee, Dae Sung Hyun, Jung Yoon Choe; Yeungnam Univ J Med. 2008;25(2):117-123. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.117

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Abstract PDF: Dermatomyositis is characterized by progressive, symmetric, proximal muscle weakness and a nonsuppurative inflammatory myopathy of unknown etiology involving predominantly skeletal muscles. It is also characterized by typical skin lesions. Interstitial lung disease has a poor prognosis when it is associated with dermatomyositis. Organizing pneumonia is a disease in which granulation tissue fills the lumina of terminal and respiratory bronchioles and extends into the distal airspaces. The cryptogenic nature of the process is appreciated in that organizing pneumonia patterns of injury can be seen in secondary forms of the disease (secondary organizing pneumonia). Organizing pneumonia has been reported to occur in 5~10% in dermatomyositis-polymyositis patients. Anti-histidyl tRNA synthetase antibody (anti-Jo-1) is a predictive disease marker that is reported to occur in up to 70% of patients. We describe a 49-year-old male dermatomyositis patient who presented with organizing pneumonia and was found to have negative anti-Jo-1 antibody.

A Case of Varicella Pneumonia Associated with Chickenpox in Immunocompetent Patient.: Won Jong Park, Sung Ken Yu, Kyeong Cheol Shin, Jin Hong Chung, Kwan Ho Lee; Yeungnam Univ J Med. 2007;24(2):339-343. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.339

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Abstract PDF: Varicella is a contagious infection in childhood disease typically affecting children aged 2-8 years and usually follows benign outcome. In the adult, clinical presentation is more severe and more commonly associated with complications. Varicella pneumonia, although rare, is a potentially life-threatening complication that should be suspected in any adult with varicella and respiratory symptoms. We report a case of varicella pneumonia in immunocompetent patient. The characteristic radiographic findings consisted of diffuse scattered coarse nodular infiltrations, less than 1cm sized, with ground glass opacity and consolidation in both lung fields. The patients was started on intravenous acyclovir. The chest radiograph performed 2 weeks later showed complete resolution of the pulmonary lesions.

Original Articles

Cloning and Sequencing of the phoA Gene which is Regulated by the phoP-phoQ operon in Pathogenic Enteric Bacteria.: Sung Kwang Kim, Tae Yoon Lee; Yeungnam Univ J Med. 1995;12(2):237-245. Published online December 31, 1995; DOI: https://doi.org/10.12701/yujm.1995.12.2.237

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Abstract PDF: The DNA fragment containing the phoA of Klebsiella pneumoniae was cloned into pACYC184. The size of the insert. was 4.0 kb and the restriction map showed it contained 3 Pstl sites and 4 PvuLI sites. The nucleotide sequence of the phoA region was determined, which showed strong (80%) sequence similarity with that of Escherichia coli. This suggested that these two species are phylogenetically very close to each other.

A Clinical Study of Mycoplasma Pneumoniae Pneumonia.: Mi Hwa Kang, Jin Gon Jun; Yeungnam Univ J Med. 1989;6(1):21-29. Published online June 30, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.1.21

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Abstract PDF: A clinical study was made on 71cases of Mycoplasma Pneumoniae Pneumonia from March, 86 to February, 89. The results were as follows; 1. Among the 315 cases of pneumonia, the incidence of mycoplasma infection was 22.5% 2. The peak incidence of age was between 5 to 9years of age (53.5%) 3. The sex ratio of male to female was 1.3:1 4. Monthly distribution showed relatively high frequency from October to January (59.2%) 5. Most common clinical symptoms were cough (98.6%) and then followed by fever (49.3%), coryza (19.7%). Rales were the most common finding (95.7%) and followed by pharyngeal injection (49.3%) and wheezing (18.3%) 6. The leukocyte counts in peripheral blood were most common in the range of 5000-10000/mm³ (47.9%) and the ESR was increased in 57.7%, and positive CRP cases were 87.3% 7. The most common radiologic finding of pulmonary infiltration was interstitial infiltration (45.1%) and then followed by disseminated lobular (39.4%) and lobar pneumonia (15.5%) 8. There are a few cases associated disease or complication: otitis media (5.6%), hepatitis (4.2%) acute glomerulonephritis, bronchial asthma and sinusitis (2.8%), thrombocytopenia (1.4%)

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