RESUMEN
Brucella endocarditis is a rare complication, but it is responsible for the majority of deaths related to this illness. A 67 year-old man presented with complaints of fever and lower back pain that he had experienced during the previous four weeks. The laboratory finding showed pancytopenia and an inverted total protein/globulin ratio. Multiple myeloma was diagnosed by bone marrow biopsy and serum electrophorosis. The spine MRI scan demonstrated spondylitis with epidural abscess (L5-S1). On the echocardiographic examination, there was vegetation on the right coronary cusp of the aortic valve and perivalvular abscess. The blood isolate was confirmed as Brucella abortus by using DNA sequencing of the 16S rRNA and the omp2a and omp2b genes. The clinical manifestations improved after appropriate antibiotics and aortic valve replacement. We describe here the first Korean case of human brucella endocarditis that was treated by valve replacement.
Asunto(s)
Humanos , Absceso , Antibacterianos , Válvula Aórtica , Biopsia , Médula Ósea , Brucella , Brucella abortus , Brucelosis , Endocarditis , Absceso Epidural , Fiebre , Dolor de la Región Lumbar , Imagen por Resonancia Magnética , Mieloma Múltiple , Pancitopenia , Análisis de Secuencia de ADN , Columna Vertebral , EspondilitisRESUMEN
The prevalence of gastroesophageal reflux disease has been increased recently in Korea. The use of minimally invasive laparoscopic and thoracoscopic surgery has become popular in the operation of esophageal disease such as esophageal cancer or gastroesophageal reflux disorder. We experienced three cases of laparoscopic Nissen fundoplications and one case of laparoscopic Collis gastroplasty, and we will describe the technical aspect of these surgeries.