• Clinical and Experimental Pediatrics
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• v.46 no.12
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• pp.1224-1229
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• 2003

Purpose : Bacterial meningitis is a serious disease, especially in the neonatal period, and it carries a significant degree of mortality and morbidity. Group B streptococcus(GBS) is a common cause of neonatal bacterial meningitis. The purpose of this study was to evaluate the clinical manifestations, treatment results and complications of GBS meningitis. Methods : We analyzed 29 cases retrospectively who had been admitted to the pediatric ward or NICU in Asan Medical Center from May 1990 to January 2002. They had proven GBS in culture or latex agglutination test in CSF. Results : The male to female ratio was 1 : 1.9. There were two cases of early onset type and 27 cases of late onset type. All cases had normal birth weight with full term at delivery. The perinatal predisposing factors were premature rupture of membrane(two cases), and maternal colonization(two cases). The most common presenting symptoms were fever and irritability. Associated diseases were GBS sepsis(21 cases). There was relatively high sensitivity to penicillin derivatives. There were abnormal brain CT or MRI findings in 16 cases(64%), such as infarction, encephalomalatic change, effusion, hydrocephalus, hemorrhage and abscess. The intensive care unit admission rate and the incidence of DIC were higher in the group with complications. Two cases were discharged against advice. Conclusion : We recommend early detection and active treatment in Group B streptococcal meningitis to improve the prognosis.

• Clinical and Experimental Pediatrics
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• v.48 no.10
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• pp.1090-1095
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• 2005

Purpose : In the case of serious respiratory distress syndrome(RDS) or relapse of clinical appearances after single treatment, we obtained more effective results with multiple-dose surfactant replacement therapy. We carried out this investigation for comparing and observing clinical progress between single-dose(group S) and multiple-dose(group M) pulmonary surfactant treatment group of neonatal RDS. Methods : We investigated 48 neonates who were diagnosed as RDS and treated with pulmonary surfactant(PS) replacement therapy in NICU of Kyunghee University hospital from January 2002 to March 2004, then we compared and verified clinical progress of 32 neonates in group S with that of 16 neonates in group M. Results : There were no significant statistical differences in average birth weights, average gestational periods, initial pH values of birth, whether operation of resuscitation at that time of birth was made or not, whether prenatal steroid prescription for mother, RDS classification standardized by Bomsel, and ventilation index(VI) before instillation of PS of two groups. However, there was significant statistical difference in a/A $PO_2$(P<0.05). We could observe changes of VI and a/A $PO_2$ within 72 hours have been continuously improved at group S rather than group M. In spite of relapses, group M changed for the better after second dose. There were also no significant differences between the two groups in duration of ventilator therapy, mortality within 28 days after birth, intraventricular hemorrhage by complication, retinopathy of premature, necrotizing enterocolitis, chronic lung diseases, sepsis, and DIC. Conclusion : In these relapse cases, as there were no significant differences in the mortality rate and the occurence of complication between group S and group M, the requirement of multiple-dose PS replacement therapy which brought improvement of prognosis was emphasized.

• Pediatric Infection and Vaccine
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• v.12 no.2
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• pp.114-123
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• 2005

Purpose : A wide, epidemic outbreak of M. pneumoniae pneumonia occurred throughout Korea in late 2003. Compared with previous years, the 2003 outbreak resulted in more severe cases and in an increased incidence of extrapulmonary symptoms and/or complications. We compared the clinical characteristics for M. pneumoniae pneumonia of 2003 to those of the past years. Methods : One hundred six children diagnosed with M. pneumoniae pneumonia by serologic tests at Bundang Cha General Hospital between Aug 2003 to April 2004 were enrolled. Medical records were reviewed retrospectively, for clinical, laboratory and radiological aspect as well as complications. The pleural effusions of 3 patients who underwent thoracentesis were also analyzed. Results : The duration of fever, cough, rhinorrhea, and sore throat was $8.2{\pm}4.7$, $22.1{\pm}4.8$, $8.4{\pm}2.1$, $4.3{\pm}1.2$ days, respectively. The incidence (percentage) and duration of abdominal pain, vomiting, diarrhea, headache, skin rash, arthralgia was $5.1{\pm}2.5$ (21.9%), $3.4{\pm}2.1$ (17.1%), $4.3{\pm}1.8$ (16.2%), $3.5{\pm}2.1$ (14.4%), $5.5{\pm}0.7$ (5.9%) and $4.6{\pm}1.3$ days (4.9%), respectively. The mean duration of admission and treatment were $7.4{\pm}4.3$ days and $21.6{\pm}11.1$ days. Higher values of CRP and ESR on admission were positively correlated with the duration of fever and length of admission. The findings of pleural effusion were similar to those seen in TB pleurisy. Complications, including myocarditis (2 cases), arthritis (3 cases), vasculitis (5 cases), asthma (3 cases), ARDS (1 case), and DIC (2 cases) were observed in 14.1% of patients. Conclusion : We found a number of characteristics of M. pneumoniae pneumonia among cases from late 2003 that were different from those of previous years. This outbreak resulted in more severe cases and in an increased incidence of extrapulmonary symptoms and/or complications. A multicenter study is needed to verify the changes in clinical characteristics observed during the 2003 outbreak from previous ones.