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REFERENCE LINKING PLATFORM OF KOREA S&T JOURNALS
> Journal Vol & Issue
Pediatric Infection and Vaccine
Journal Basic Information
Journal DOI :
The Korean Society of Pediatric Infectious Diseases
Editor in Chief :
Volume & Issues
Volume 21, Issue 3 - Dec 2014
Volume 21, Issue 2 - Aug 2014
Volume 21, Issue 1 - Apr 2014
Selecting the target year
Clinical and Laboratory Findings of the 2012 Winter Seasonal Influenza A and B Outbreak at a Single Institution
Choi, Jae Won ; Cho, Hyun Jun ; Kim, Hwang Min ; Hahn, Seok ;
Pediatric Infection and Vaccine, volume 21, issue 1, 2014, Pages 1~8
DOI : 10.14776/kjpid.2014.21.1.1
Purpose: The aim for this study was to investigate clinical manifestation of seasonal influenza A and B during the 2012 winter season in Wonju, South Korea. Their clinical and laboratorial characteristics and effect of oseltamivir were compared and analyzed. Methods: Children under the age of 18 years who visited the Wonju Severance Christian Hospital with fever or acute respiratory symptoms and who were diagnosed with influenza A or B by rapid antigen test from nasopharyngeal swab were selected for the study. The medical records of patients were retrospectively reviewed. Results: Influenza A was detected in 374 patients (83.7%), and influenza B in 72 (16.6%). The incidence of influenza A was highest in February (n=186), while that of influenza B was highest in March (n=36). The most common symptoms were fever (n=434, 97.1%) and cough (n=362, 81.0%). No significant differences were observed between influenza A and B in symptoms and laboratory data. Patients who had used oseltamivir within 2 days showed statistically lower admission rate, shorter admission duration, and lower incidence of pneumonia. Conclusion: This study found no statistical difference between influenza A and B, in symptoms, progression, and laboratory test, but those who were treated with oseltamivir given within 2 days of the onset of fever experienced more positive outcomes.
Voriconazole Therapeutic Drug Monitoring is Necessary for Children with Invasive Fungal Infection
Kang, Hyun Mi ; Kang, Soo Young ; Cho, Eun Young ; Yu, Kyung-Sang ; Lee, Ji Won ; Kang, Hyoung Jin ; Park, Kyung Duk ; Shin, Hee Young ; Ahn, Hyo Seop ; Lee, Hyunju ; Choi, Eun Hwa ; Lee, Hoan Jong ;
Pediatric Infection and Vaccine, volume 21, issue 1, 2014, Pages 9~21
DOI : 10.14776/kjpid.2014.21.1.9
Purpose: To determine the clinical significance of voriconazole therapeutic drug monitoring (TDM) in the pediatric population. Methods: Twenty-eight patients with invasive fungal infections administered with voriconazole from July 2010 to June 2012 were investigated retrospectively. Fourteen received TDM, and 143 trough concentrations were analyzed. All 28 patients were assessed for adverse events and treatment response six weeks into treatment, and at the end. Results: Out of 143 samples, 53.1% were within therapeutic range (1.0-5.5 mg/L). Patients administered with the same loading (6 mg/kg/dose) and maintenance (4 mg/kg/dose) dosages prior to initial TDM showed highly variable drug levels. Adverse events occurred in 9 of 14 patients (64.3%) in both the TDM and non-TDM group. In the TDM group, voriconazole-related encephalopathy (n=2, 14.3%) and aspartate aminotransferase (AST) or alanine aminotransferase (ALT) elevation (n=8, 57.1 %) occurred with serum levels in the toxic range (>5.5 mg/L), whereas blurred-vision (n=2, 14.3%) occurred within the therapeutic range (1.18 mg/L and 3.9 mg/L). The frequency of voriconazole discontinuation due to adverse events was lower in the TDM group (0.0% vs. 18.2%, P =0.481). Overall, 57.2% of the patients in the TDM group versus 14.3% in the non-TDM group showed clinical response after 6 weeks (P =0.055), whereas 21.4% in the TDM group versus 14.3% in the non-TDM group showed response at final outcome (P =0.664). In the TDM group, >67.0% of the serum levels were within therapeutic range for the first 6 weeks; however 45.5% were within therapeutic range for the entire duration. Conclusion: Routine TDM is recommended for optimizing the therapeutic effects of voriconazole.
Risk Factors Associated with Respiratory Virus Detection in Infants Younger than 90 Days of Age
Eem, Yeun-Joo ; Bae, E Young ; Lee, Jung-Hyun ; Jeong, Dae-Chul ;
Pediatric Infection and Vaccine, volume 21, issue 1, 2014, Pages 22~28
DOI : 10.14776/kjpid.2014.21.1.22
Purpose: This study aimed at determining the detection rate of respiratory viruses and at investigating the risk factors associated with respiratory virus detection in young infants. Methods: From September 2011 to August 2012, nasopharyngeal swabs were obtained from 227 infants aged
days with suspected infectious diseases, including sepsis. We performed a retrospective analysis of their clinical characteristics. The prevalence of respiratory viruses in their nasopharyngeal swabs was assayed by real-time polymerase chain reaction (real-time PCR). Results: In total, 157 (69.2%) infants had more than one of the following respiratory viruses: respiratory syncytial virus (n=75), rhinovirus (n=42), influenza virus (n=18), parainfluenza virus (n=15), human metapneumovirus (n=9), coronavirus (n=9), adenovirus (n=4), and bocavirus (n=3). During the same period, bacterial infections were confirmed in 24 infants (10.6%). The detection of respiratory viruses was significantly associated with the presence of cough, a family history of respiratory illness, and a seasonal preference (fall/winter). Using logistic regression analysis, these 3 variables were also identified as significant risk factors. During fall and winter, detection of respiratory viruses was significantly higher in infants who did not have a bacterial infection. Conclusion: Respiratory virus is an important pathogen in young infants admitted to a hospital, who are suspected with infectious diseases. Detection of respiratory viruses in young infants was associated with seasonality (fall/winter), presence of respiratory symptoms and a family history of respiratory illness.
Prediction of Intravenous Immunoglobulin Nonresponse Kawasaki Disease in Korea
Choi, Myung Hyun ; Park, Chung Soo ; Kim, Dong Soo ; Kim, Ki Hwan ;
Pediatric Infection and Vaccine, volume 21, issue 1, 2014, Pages 29~36
DOI : 10.14776/kjpid.2014.21.1.29
Purpose: The objective of this study was to find the predictors and generate a prediction scoring model of nonresponse to intravenous immunoglobulin in patients with Kawasaki disease. Methods: We examined 573 children diagnosed with KD at the Severance Children's Hospital between January 2009 and december 2012. We retrospectively reviewed their medical records. These patients were divided into 2 groups; the experimental group (N=433) and the validation group (N=140). Each group were divided into 2 groups the intravenous immunoglobulin nonresponders and the responders. Multivariate logistic regression analysis identified predictive factors of intravenous immunoglobulin nonresponders which make predictive scoring model. We practice internal validation and external validation. Results: Multivariate logistic regression analysis identified male, cervical lymphadenopathy, changes of the extremities, platelet, total bilirubin, alkaline phophatase, lactate dehydrogenase, C-reactive protein as significant predictors for nonresponse to intravenous immunoglobulin. We generated prediction score assigning 1 point for (1) male, (2) cervical lymphadenopathy, (3) changes of the extremities, (4) platelet (
), (5) total bilirubin (
), (6) alkaline phophatase (
), (7) lactate dehydrogenase (
), (8) C-reactive protein (>77.1 mg/dL). Using a cut-off point of 4 and more with this prediction score, we could identify the intravenous immunoglobulin nonresponder group. Sensitivity and specificity were 52.5% and 82.4% in experimental group and 37.8% and 81.8% in validation group, respectively. Conclusion: Our predictive scoring models had high specificity and low sensitivity in Korean patients. Therefore it is useful in predicting nonresponse to intravenous immunoglobulin with Kawasaki disease.
Clinical Manifestations, Management, and Natural Course of Infants with Recurrent Bronchiolitis or Reactive Airways Disease
Park, Hyoun Jin ; Kim, Joo Hyun ; Chun, Yoon Hong ; Lee, Soo Young ; Kim, Sang Yong ; Kang, Jin Han ;
Pediatric Infection and Vaccine, volume 21, issue 1, 2014, Pages 37~42
DOI : 10.14776/kjpid.2014.21.1.37
Purpose: The purpose of this study was to investigate the clinical manifestations and 5-year natural course of recurrent bronchiolitis or reactive airways disease (RAD) in infants. Methods: We reviewed the medical records of infants with recurrent bronchiolitis from January 2007 to December 2007 at The Catholic University of Korea St. Mary's Hospital in Incheon, South Korea. Additionally, we telephoned their parents to confirm their present medical statuses. Results: Sixty-three subjects with recurrent bronchiolitis were identified. The mean age at admission was 8.1 months and the number of males was 44 (69.8%). Of the 63 infants with recurrent bronchiolitis, inhaled corticosteroids, bronchodilators, and antibiotics were given to 62 (98.4%), 53 (84.1%), and 40 (63.5%), respectively. Among the total 63 subjects, we were able to contact the parents of 45 children by telephone. None of these children had been hospitalized during the previous one year period due to respiratory infections or for other medical reasons. Of the 45 subjects we were able to contact, 38 (84.4%) had not experienced any further respiratory difficulties at all. Five (11.1%) had been diagnosed with allergic rhinitis while two (4.4%) were being managed for asthma. Conclusion: Most children who presented with recurrent episodes of bronchiolitis in infancy did not show any further respiratory difficulties after five years of age.
Comparison among Known Severity Scoring Scales in the Evaluation of Acute Gastroenteritis in Children
Choi, Jee-Hyun ; Jung, Tae Woong ; Kim, Seong Joon ; Chung, Ju-Young ; Kim, Min-Sung ; Han, Seung Beom ; Kang, Jin-Han ; Kim, Sang Yong ; Rhim, Jung Woo ; Kim, Hwang-Min ; Park, Jae Hong ; Jo, Dae Sun ; Ma, Sang Hyuk ; Jeong, Hye-Sook ; Cheon, Doo-Sung ; Koh, Dae Kyun ; Kim, Jong-Hyun ;
Pediatric Infection and Vaccine, volume 21, issue 1, 2014, Pages 43~52
DOI : 10.14776/kjpid.2014.21.1.43
Purpose: This study aimed to evaluate the disease severity of children suffering from gastroenteritis using different scales. The results are compared and subsequently classified on the basis of the type of virus causing the disease in order to investigate the differences in clinical characteristics and disease severity according to pathogen. Method: This study was conducted prospectively with patients under 5 years of age diagnosed with acute gastroenteritis and hospitalized at 9 medical institutions in 8 regions across the Republic of Korea. Disease severity was evaluated using the Vesikari Scale, the Clark Scale, and the modified Flores Scale. Fecal samples collected from patients were used to detect rotavirus and enteric adenovirus by enzyme immunoassay, and for RT-PCR of norovirus, astrovirus, and sapovirus. Results: There were a total of 214 patients with a male : female ratio of 1.58 : 1, of which 35 were under the age of 6 months (16.4%), 105 were aged 6-23 months (49.1%), and 74 were aged 24-59 months (34.5%). The rate of concordance between the Vesikari and Clark Scales was 0.521 (P<0.001) and, in severe cases, the Vesikari Scale was 60.7% and Clark Scale was 2.3%, indicating that the Clark Scale was stricter in the evaluation of severe cases. Conclusions: In children with gastroenteritis, there were differences in disease severity based on the scale used. Therefore, to achieve consistent results among researchers, either only a single scale or a measure of all scales should be used to determine disease severity.
A Case of Esophageal Obstruction Complicated in a Patient with Chronic Granulomatous Disease - Esophageal obstruction in Chronic Granulomatous Disease
Kim, Ji Soo ; Hwang, Jinsol ; Choi, Young Hun ; Kim, Woo Sun ; Kim, Joong Gon ;
Pediatric Infection and Vaccine, volume 21, issue 1, 2014, Pages 53~58
DOI : 10.14776/kjpid.2014.21.1.53
Chronic granulomatous disease (CGD) is an inherited immunodeficient disease characterized by recurrent infections and granuloma formation. Granulomatous obstruction of esophagus is one of the rare complications of CGD. The use of steroids and antimicrobials for esophageal obstruction by granuloma in CGD patients has been controversial due to the possibility of concomitant inapparent infection. We report a case of esophageal obstruction in an 8-year-old CGD patient showing the poor response to antibiotics therapy. However, dramatic improvement of symptoms and radiologic findings of esophageal obstruction were achieved after steroid therapy. One month after discontinuation of steroid, esophageal obstruction recurred and the patient was re-treated with steroid. After that time, he experienced one more recurrence of esophageal obstruction. This symptom subsided after antibiotics therapy without steroid and he has been followed up to the present without further relapse.
A Case of Subdural Empyema Caused by Sinusitis in a Child
Byun, Jung Hee ; Hwang, In Kyung ; Park, Eun Kyung ; Kang, Ju Wan ; Kim, Dong Soo ; Jang, Gwang Cheon ;
Pediatric Infection and Vaccine, volume 21, issue 1, 2014, Pages 59~64
DOI : 10.14776/kjpid.2014.21.1.59
The current paper reports on a case of subdural empyema secondary to frontal sinusitis in an otherwise healthy child. Sinusitis is a common and benign condition in most pediatric cases. Because of the widespread use of antibiotics, intracranial extension of pediatric sinusitis is rarely seen today; however, complications (e.g., cavernous sinus thrombosis, orbital infection, meningitis, and subdural empyema) are potentially life threatening. A 15-year-old right-handed male presented with a 3-day history of fever, headache, and left-sided palsy. Computed tomography revealed right-sided subdural empyema with right frontal sinusitis and maxillary sinusitis. A postoperative inpatient neurological consultation was requested 2 months post-surgery due to motor function deficits. The results suggested that early and accurate diagnosis of subdural empyema leads to prompt treatment and a favorable outcome for the patient.
Congenital Syphilis: An Uncommon Cause of Gross Hematuria, Skin Rash, and Pneumonia
Shim, Sun Hee ; Kim, Ju Young ; Lee, Eu Kyoung ; Bang, Kyongwon ; Cho, Kyoung Soon ; Lee, Juyoung ; Suh, Jin-Soon ; Bin, Joong Hyun ; Kim, Hyun Hee ; Lee, Won Bae ;
Pediatric Infection and Vaccine, volume 21, issue 1, 2014, Pages 65~70
DOI : 10.14776/kjpid.2014.21.1.65
Although congenital syphilis can be prevented with prenatal screening, the disease remains problematic. Currently, there are no cases that describe hematuria and pneumonia related to congenital syphilis. We report a case of congenital syphilis that involved nephrotic syndrome and pneumonia alba in a 22-day-old male infant whose mother did not receive adequate prenatal care. The congenital syphilis diagnosis was confirmed with a serologic test and the patient recovered with penicillin treatment. Clinical findings may be subtle in neonates and delayed recognition occurs frequently, thus complete prenatal screening is critical for congenital syphilis prevention. Immediate serologic testing should be performed to obtain a differential diagnosis if an infant is delivered by a mother that has not received appropriate prenatal examinations.