Electrolyzed acid water is as efficient as glutaraldehyde in eliminating bacteria from patient-used endoscopes. After disinfection procedures using both methods, HBV-DNA was not detected from any endoscopes experimentally contaminated with HBV-positive mixed sera. However, some bacteria may remain on the surface of the endoscopes. Therefore, more careful precleaning of the endoscopes may help achieve high-level disinfection in the clinical setting.

Chronic active Epstein-Barr virus (CAEBV) infection is characterized by persistent infectious mononucleosis-like symptoms, an unusual pattern of Epstein-Barr virus (EBV) antibodies, detection of the EBV genome in affected tissues or peripheral blood, and chronic illness that cannot be attributed to any other known disease. This is the first reported Korean case of an immunocompetent adult with CAEBV-associated interstitial pneumonitis. A 28-year-old female was admitted with a fever that persisted for 3 weeks. She had multiple lymphadenopathy, hepatosplenomegaly, pancytopenia, and elevated serum aminotransferase levels. Serology for antibodies was positive and chest computed tomography showed diffuse ground glass opacities in both lungs. Histopathology of the lung tissue showed lymphocyte infiltration, and EBV DNA was detected in those lymphocytes using in situ hybridization with an EBV-encoded RNA probe. After 1 month of hospitalization, she improved without specific treatment.

A 62-year-old woman presented with a 10-day history of headache and progressive right hemiparesis. There was no known underlying disease. A contrast-enhanced magnetic resonance imaging of the brain revealed rim enhancing lesions with associated edema located in the left cingulated gyrus and right parietal lobe (Fig. 1). A craniotomy was performed to drain the abscess. The obtained thick, yellow purulent material yielded Grampositive bacilli with branching fine filamentous forms, identified as Nocardia species. The fungus was not detected by culture technique using drained abscess fluid. Treatment with trimethoprim-sulfamethoxaole (TMP-SMX) was initiated post-operatively. During the post-operative management, two pulmonary nodules were detected incidentally ( Fig. 2A). We considered the pulmonary nodules to be nocardiosis at that time, and did not perform any further diagnostic procedures. After one month of INTRODUCTIONNocardia spp. was first described by Nocard in 1888 as a fungus and was further classified as a gram-positive, aerobic bacterium that belongs to the genus Nocardia, order Actinomycetales 4) . The central nervous system (CNS) is the most commonly involved site in disseminated nocardiosis. CNS involvement has been recognized in over 44% of all cases of systemic nocardiosis in one large study 1) . Nocardia cerebral abscesses are rare and generally occur in patients with defects in cell-mediated immunity. Nocardial abscesses account for 2% of brain abscesses and may occur as an isolated CNS lesion without evidence of extracranial disease, or as part of a disseminated infection in association with pulmonary or cutaneous disease 11) . Insidious presentations are often mistaken for neoplasia because of the paucity of clinical and laboratory signs of bacterial inflammation; the silent invasion and persistence make diagnosis and management more difficult. If a patient with cerebral nocardiosis has multiple pulmonary nodules, we presume that they reflect a pulmonary nocardiosis.Here, we report the first case of concurrent nocardial abscess and semi-invasive pulmonary aspergillosis in an immunocompetent patient. We describe here the first case of a concurrent brain abscess caused by Norcardia spp. and semi-invasive pulmonary aspergillosis in an immunocompetent patient. After one year of appropriate antimicrobial therapy and surgical drainage of the brain abscess, the nocardia brain abscess and pulmonary aspergillosis have resolved.