A 80-yr-old man with watery sputum 30YA DM Dx. medication 중 1YA BPH Dx. local clinic 에 3 개월 medication 하다가 07.3 월 본원 URO OPD visit, tamsolucin 복용 중 10YA.

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Presentation transcript:

A 80-yr-old man with watery sputum 30YA DM Dx. medication 중 1YA BPH Dx. local clinic 에 3 개월 medication 하다가 07.3 월 본원 URO OPD visit, tamsolucin 복용 중 10YA bronchiectasis Dx. medical F/U 해옴 11 MA cough, sputum 증가, Wt. Loss 평소 1 년에 1 차례 정도 hemoptysis 있었으나, 이때부터 수일에 한번 정도로 발생함. 7 MA cough, sputum 증가한 상태로 hemoptysis 발생하여 ER visit  bronchial artery mbolization Bronchoscopy finding; no endobronchial lesion, BAL fluid: AFB(-)/ TB PCR (-) 6 MA TB PCR (+)  pulmonary TB 로 Medication 2 MA cough, sputum 다시 증가 하는 양상 chest X-ray 병변 악화되어 moxicle 투여, 이후에도 watery sputum 양 증가하는 양상으로 w/u 및 iv antibiotics 사용 위해 입원치료. 수술위해 입원

Chest PA and lateral: Finding suggestive of bronchiectasis with mucus plugging

Chest CT: Tree-in-bud sign and centrilobular nodules

Chest CT: Bronchiectasis and tree-in-bud sign and centrilobular nodules

Diffuse inflammatory process along the airway, distal cystic change and actinomycotic colonies

Filamentous bacterial organisms, Actinomycosis