면역저하가 없는 환자에서 Alcaligenes xylosoxidans에 의한 호흡기계 감염 2예

A. xylosoxidans는 면역저하 상태에서 기회감염을 일으키며 호흡기 감염은 매우 드문 균으로 알려져 있다. 저자들은 최근 면역저하가 없는 환자에서 발생한 A. xylosoxidans에 의한 호흡기 감염증을 2예 경험하였기에 문헌 고찰과 함께 보고한다. 본 증례를 통해 정상면역을 가진 환자에서 A. xylosoxidans가 호흡기 감염의 원인일 수 있으며, 이와 같은 경우 세균학적 검사결과에 따른 적절한 치료가 필수적이라는 것을 경험하였다. Alcaligenes xylosoxidans is a catalase and oxidase positive, motile, nonfermentative and gram-negative rod bacterium. A. xylosoxidans infection is a rare cause of pulmonary infection and little information concerning treatment is available. The majority of patients that develop A. xylosoxidans infection belong to a high-risk group due to an immunocompromised condition or due to pulmonary cystic fibrosis. We report two rare cases of immunocompentent patients that developed a pulmonary infection due to A. xylosoxidans. A 77-year-old man was admitted with a lung abscess. The patient denied having any prior medical illness. A culture of bronchial washing fluid showed the presence of A. xylosoxidans. Despite appropriate antibiotic treatment, the patient died from acute respiratory distress syndrome (ARDS). Another patient, a 61-year-old man without an underlying disease, was admitted with empyema. Under the condition of a closed thoracostomy, a high fever persisted and the empyema was also aggravated. A. xylosoxidans was detected from a culture of pleural fluid. Susceptible antibiotic treatment was provided and surgical intervention was performed. We report these cases with a review of the literature. (Tuberc Respir Dis 2008;64:33-38)