RESUMO
Tetanus is a neurologic disorder caused by a tetanospasmin released from Clostridium tetani and usually occurs following a stab wound or dirty abrasion. Tetanus is uncommon in Korea due to the introduction of vaccination programs. Furthermore, tetanus associated with a gangrenous perforation of the small bowel is extremely rare. We report a case of tetanus developed in a patient who was diagnosed with a gangrenous perforation of the small bowel. This is the first reported case in Korea.
Assuntos
Humanos , Clostridium tetani , Procedimentos Cirúrgicos do Sistema Digestório , Perfuração Intestinal , Coreia (Geográfico) , Metaloendopeptidases , Doenças do Sistema Nervoso , Tétano , Toxina Tetânica , Vacinação , Ferimentos PerfurantesRESUMO
BACKGROUND: Methotrexate (MTX) has been used to treat a wide range of malignant and benign diseases including osteosarcoma, advanced stage non-Hodgkin's lymphoma, psoriasis, severe rheumatoid arthritis, sarcoidosis, and Wegener's granulomatosis. MTX-induced lung injury occurs in up to 10% of treated patients. Although both acute and chronic presentations have been described, typical manifestation of MTX-induced lung injury is subacute with symptoms usually developing within several months after starting therapy. Nonspecific interstitial pneumonia (NSIP) is the most common histopathologic manifestation of MTX-induced lung disease, while bronchiolitis obliterans organizing pneumonia (BOOP) and diffuse alveolar damage (DAD) are less common. Granuloma formation is reported in 34.7%. In Korea, Two reports of MTX pneumonitis have been published. The one presented with NSIP and the other with DAD. We recently experienced a case of MTX pneumonitis with presentation of hypersensitivity pneumonitis.
Assuntos
Humanos , Alveolite Alérgica Extrínseca , Artrite Reumatoide , Pneumonia em Organização Criptogênica , Granuloma , Hipersensibilidade , Coreia (Geográfico) , Pneumopatias , Doenças Pulmonares Intersticiais , Lesão Pulmonar , Linfoma não Hodgkin , Metotrexato , Osteossarcoma , Pneumonia , Psoríase , Sarcoidose , Granulomatose com PoliangiiteRESUMO
BACKGROUND: Sputum smears for acid-fast bacilli(AFB) examined microscopically is the most important diagnostic test for pulmonary tuberculosis. However, the AFB observed on the smear may represent either M. tuberculosis or nontuberculous mycobacteria(NTM). This study examined the recovery rate of NTM from the AFB smear-positive sputum specimens in a tertiary hospital in Korea. MATERIALS AND METHODS: This study analyzed the results for the 1,889 AFB smear-positive and culture-positive sputum specimens collected from 844 patients from July, 1997 to December, 2001. RESULTS: The 1,889 sputum specimens collected from 844 patients tested positive on both microscopy and culture during the 4.5 years. The NTM were recovered from 10.3%(195/1,889) of the smear-positive sputum specimens and 11.0%(93/844) of patients with smear-positive sputum. The NTM were isolated more than two times in 44.1%(41/93) of the patients from whom the NTM was recovered. Trends of the recovery rate of the NTM from the AFB smear-positive sputum specimens were increasing from 6.5%(17/262) in the latter half of 1997 to 17.8%(36/202) in the latter half of 2001 (p<0.001, test for trend). CONCLUSIONS: These results suggest that some patients with AFB smear-positive sputum have NTM pulmonary disease rather than pulmonary tuberculosis in Korea.