A Case of Nocardiosis after Bone Marrow Transplantation / 감염

The nocardiae are gram-positive, aerobic actinomycetes causing opportunistic infections in compromised hosts, such as recipients of solid organ transplants, patients with AIDS, and patients with cancer receiving immunosuppressive therapy, and those with chronic illnesses. Because cellular immunity and neutrophil function are critical for the clearance of Nocardia, frequent infection with the organism would be expected amongmarrow recipients, but reports of nocardiosis are surprisingly rare among these patients. We report a case of nocardiosis sixteen months after an allogenic bone marrow transplantation. The patient was successfully treated with imipenem and amikacin for 4 weeks and then with oral trimethoprim-sulfamethoxazole.

A case of Klebsiella pneumonia & Bacteremia Following Flexible Fiberoptic Bronchoscopy / 병원감염관리

Flexible fiberoptic bronchoscopy is a useful tool for the diagnosis and management for diseases of the airway. Although it has been known to be a relatively safe procedure; in some cases, mild complications can occur after fiberoptlc bronchoscopy. However, fatal complications such as bacteremia, pneumonia, myocardial infarction, severe obstruction of the airways, respiratory failure or death have been reported. Among them, infectious complications following flexible fiberoptic bronchoscopy occur sometimes, although most of them are self-limited. We recently experienced a case of severe Klebsiella pneumoniae pneumonia in a patient presenting with fever following flexible fiberoptic bronchoscopy, We report this case to discuss the potential complications of fiberoptic bronchoscopy with a review of literature.

A Case of Primaquine-Resistant Tertian Malaria / 감염

Plasmodium vivax has many stages in the life cycle, and shows different susceptibilities to anti-malarial drugs at each stage. Of these drugs, primaquine is only drug that has anti-malarial activity to hypnozoite. Generally, primaquine is administered for the prevention of relapse by hypnozoite following the treatment with chloroquine in tertian malaria, at the dosage of 15mg/ day for 14 days. But Plasmodium vivax has different susceptibility to primaquine in different areas (so as to strains), and the resistance to primaquine is increasing in endemic areas. We recently experienced a case of imported tertian malaria that relapsed two times after the completions of chloroquine-primaquine therapy. The patient was treated with 22.5 mg of primaquine for 2 weeks at the first relapse, and 3 weeks course of 30 mg of primaquine in the second relapsing episode. Therefore we report this primaquine-resistant tertian malaria with review.