• Clinical and Experimental Pediatrics
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• v.51 no.10
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• pp.1071-1076
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• 2008

Purpose : Respiratory syncytial virus (RSV) is the most frequent cause of lower respiratory infections in infants and young children. Early detection allows quarantining of infected inpatients to prevent nosocomial transmission and to choose a treatment. To achieve rapid reporting, to facilitate prompt antiviral therapy, and to avoid unnecessary use of antibiotics, an easy, rapid diagnostic method for RSV is needed. We evaluated a lateral flow immunochromatography (RSV Respi-Strip test) and EIA (Enzyme immuno assay) compared to RT-PCR. Methods : From April 2007 to March 2008, 112 consecutive respiratory specimens (nasopharyngeal aspirates, throat swabs, tracheal aspirates, sputum) from patients who were suffering from the clinical signs and symptoms of respiratory tract infection were enrolled in Busan. A total of 112 patients were tested with RSV Respi-Strip (Corio-BioConcept, Belgium), EIA, and RT-PCR at the same time. Results : Of the 112 specimens tested, the number of children who showed positive results at RT-PCR and Respi-Strip were 45 and 42, respectively. The Respi-Strip rapid antigen test had a sensitivity of 88% and a specificity of 94%. The positive and negative predictive values were 90% and 92%, respectively. The agreement was 83%. Conclusion : In our study, the rapid antigen test had as much sensitivity as any method for detection of RSV. The test has many advantages such as easy performance, simple interpretation, and rapid results. If the rapid antigen test is widely applied in the clinical setting, the may be useful for diagnostic and epidemiological studies of RSV infection.

• Clinical and Experimental Pediatrics
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• v.52 no.9
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• pp.1048-1052
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• 2009

Plastic bronchitis is a rare disease characterized by the recurrent formation of branching mucoid bronchial casts that are large and more cohesive than those that occur in ordinary mucus plugging. Casts may vary in size and can be spontaneously expectorated, but some require bronchoscopy for removal. Plastic bronchitis can therefore present as an acute life-threatening emergency if obstruction of the major airways occurs. Three of 22 reported patients with eosinophilic casts were fatal, with death due to central airway obstruction. Here, we report a child with no history of atopy, allergy, or congenital heart disease who was diagnosed with plastic bronchitis with eosinophilic casts. Although he was administered intravenous (iv) antibiotics; iv corticosteroids; and a vigorous pulmonary toilet regimen, including chest physiotherapy and routine bronchoscopic removal of casts, he had brain death secondary to hypoxic brain damage. Plastic bronchitis can be fatal when casts obstruct the major airways, as in the present case. Clinicians should intervene early if a patient exhibits signs and symptoms consistent with plastic bronchitis.

• Tuberculosis and Respiratory Diseases
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• v.65 no.2
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• pp.147-151
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• 2008

Non-resolving or slowly resolving pulmonary infiltrates in spite of administering adequate antimicrobial therapy are a clinical diagnostic challenge for physicians. The rate of radiographic resolution varies with the patients' age, the underlying comorbidities, the extent of radiographic involvement, the functional status and the causal pathogens. It is important to differentiate non-resolving or slowly resolving bacterial pneumonia from other uncommon infectious pneumonias or malignancies that require invasive diagnostic techniques to confirm the diagnosis. Bronchioloalveolar carcinoma can present with various clinical and radiographic features. Unfortunately, the radiographic similarity of consolidative BAC to pneumonia often leads to an incorrect diagnosis of pneumonia and possibly significant delays in obtaining appropriate diagnostic studies. We describe here a case of a mixed adenocarcinoma and bronchioloalveolar carcinoma that was initially diagnosed as pneumonia due to the consolidation pattern on the radiography and the patient's initial improvement with antibiotic treatment.

• Pediatric Infection and Vaccine
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• v.22 no.1
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• pp.29-35
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• 2015

Purpose: The purpose of this study was to investigate the clinical characteristics and outcome of febrile urinary tract infections (UTIs) caused by community-acquired extended-spectrum ${\beta}$-lactamase (CA-ESBL)-producing and -nonproducing bacteria. Methods: We analyzed febrile UTIs in children hospitalized at Gachon University Gil Medical Center from January 2011 to December 2013 through retrospective data collection from their medical records. Results: Among pathogens causing 374 episodes of UTIs, the proportion of ESBL-producing bacteria was 13.1% (49/374). The proportion of ESBL-producing Escherichia coli and Klebsiella spp. was 13.6% (48/354) and 5.0% (1/20), respectively. There was no significant difference between the CA-ESBL and CA non-ESBL groups in duration of fever ($4.2{\pm}2.7$ vs. $3.7{\pm}2.1$ days, P=0.10) and bacterial eradication rate with empirical antibiotics (100% vs. 100%). The risk of cortical defects on renal scan significantly depended on existence of vesicoureteral reflux rather than ESBL production of pathogen. Conclusions: There was no significant difference between the CA-ESBL and CA non-ESBL groups in renal cortical defects and clinical outcome. Careful choice of antibiotics is important for treatment of community-acquired UTI in children.

• Pediatric Infection and Vaccine
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• v.22 no.1
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• pp.23-28
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• 2015

Purpose: The aim of this study was to investigate the clinical manifestations and laboratory characteristics of eosinophilic meningitis in Severance Children's Hospital. Methods: We examined 6,335 children under the age of 18 years old who had visited the tertiary hospital in Seoul, Korea, and had received cerebrospinal study results between January 2007 and July 2012. The medical records of the patients identified as eosinophilic meningitis were retrospectively reviewed. Results: Eosinophilic meningitis was diagnosed in 39 patients (0.6%). The mean age was 6 years (range 0-18 years) and the sex ratio was 1.3:1 (22 males and 17 females). The underlying diseases and past history were neurologic disease (n=36, 92%). Eosinophilic meningitis was diagnosed in thirty-five patients who had undergone postoperation neurosurgery (90%). The most common symptoms were fever (50%), headache (20%), vomiting (15%), seizure (10%), and dizziness (5%). The average duration for recovery was five days, and intravenous antibiotics or steroids were used. Conclusions: Manifestations of eosinophilic meningitis are similar to other types of meningitis. The most common cause of eosinophilic meningitis in children was neurosurgery. Eosinophilic meningitis should be considered for patients showing fever and headache after neurosurgery. Through careful investigation, use of improper antibiotics could be avoided.

• Pediatric Infection and Vaccine
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• v.15 no.2
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• pp.206-211
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• 2008

Streptococcus pneumoniae is a common cause of acute otitis media, sinusitis, pneumonia, and the invasive bacterial infections in children. Rarely, S. pneumoniae is an uncommon cause of hemolytic-uremic syndrome (HUS). We report a 33 month-old girl who presented with pneumonia, and subsequently developed HUS. Her pulmonary infection was complicated by necrotizing pneumonia and acute respiratory distress syndrome. Cultures from blood and pleural fluid grew S. pneumoniae, serotype 19A. She was treated with antibiotics, dialysis and mechanical ventilatory support. She was discharged with normal renal function after 2 months of management. She remained healthy without renal complications at the 5 year follow-up visit.

• Tuberculosis and Respiratory Diseases
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• v.65 no.5
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• pp.410-415
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• 2008

Bronchiolitis obliterans (BO) is a serious noninfectious complication following an allogeneic bone marrow transplant (BMT). A 21-year-old female received an allogeneic BMT as a treatment for myelodyplastic syndrome. Four months after the BMT, progressive dyspnea developed and BO was also diagnosed by a lung biopsy. The patient was administered steroid and immunosuppressive agents for 1 year but there was no improvement in pulmonary function. Azithromycin was prescribed (500 mg q.d. for 3 days followed by 250 mg three time a week) because macrolides might decrease the inflammatory reaction leading to BO. The patient's pulmonary function improved after administration of azithromycin for 1 year. The forced expiratory volume in a one second ($FEV_1$) increase was 220 mL (28.2%) and the forced vital capacity (FVC) increase was 460 mL (25.7%). We report the improvement in the pulmonary function after the administration of azithromycin for 1 year in a patient with BO after a BMT.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.6
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• pp.427-431
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• 2018

We report a case of a patient with necrotizing fasciitis followed by liver abscess. A 51-year-old man was admitted to our hospital with a 5-day history of fever and chills with painful swelling of the right thigh. A magnetic resonance imaging (MRI) scan showed fluid collection with numerous dark signal intensities considered as air-bubbles between the posteromedial and posterolateral groups of the right thigh, resulting in presumptive diagnosis of necrotizing fasciitis. At the time of admission, an ultrasonograph of the abdomen showed increased parenchymal echogenicity of both kidneys and no liver abscess. Ten days after fasciotomy, an abdominal computed tomography (CT) scan showed intrahepatic abscess. Sonography-guided percutaneous drainage was performed. Both cultures of pus specimens from the liver abscess and right thigh yielded Klebsiella pneumoniae (K. pneumoniae). The patient was treated with fasciotomy several times and parenteral antibiotics, after which he began to improve. After 5 weeks, liver abscess size was reduced, and after 10 weeks, liver abscess disappeared. To the best of our knowledge, this is the first case of K. pneumoniae-necrotizing fasciitis followed by liver abscess.

• Korean Journal of Poultry Science
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• v.44 no.3
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• pp.181-188
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• 2017

Bacteriophages are viruses that exclusively infect bacterial cells, and lytic bacteriophages can be used as a safe alternative to antibiotics for the prevention and treatment of animal diseases. In this study, we attempted to isolate and characterize bacteriophages for Salmonella enterica serovar Gallinarum (Salmonella Gallinarum), the causative agent of fowl typhoid in chickens. Ten bacteriophages were isolated from samples of sewage from seven poultry slaughterhouses. One of these isolate, designated as $SG{\Phi}-YS$ SP and classified in the family Myoviridae, produced plaques with seven Salmonella Gallinarum strains. However, no plaques were produced with any of the Salmonella enterica serovar Enteritidis strains tested, suggesting that this bacteriophage is Salmonella Gallinarum specific. To assess the lytic ability of $SG{\Phi}-YS$ SP against Salmonella Gallinarum, bacterial growth rates following inoculation of the bacteriophage were compared with the control. The $SG{\Phi}-YS$ SP treatment, with a multiplicity of infection of 10, reduced the growth of Salmonella Gallinarum by 2.21 log cfu/mL at 6 h, and 2.13 log cfu/mL at 9 h, suggesting that this bacteriophage isolate could be used for the prevention or treatment of Salmonella Gallinarum infection in chickens.

• Pediatric Infection and Vaccine
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• v.27 no.1
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• pp.69-76
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• 2020

Recurrent bacterial meningitis is the reappearance of two or more episodes of meningitis caused by a different or same organism after an intervening period of full convalescence. Predisposing factors for recurrent bacterial meningitis include immunodeficiency and developmental and traumatic anatomical defects. Therefore, careful evaluation of children with recurrent meningitis is essential. We report the case of a patient with a skull base abnormality who had suffered from four events of bacterial meningitis between 8 and 17 years of age. He experienced another event of bacterial meningitis at the age of 21, without undergoing correction for the anatomical defect. Streptococcus agalactiae was identified in the patient's blood and cerebrospinal fluid culture. Afterwards, he underwent surgical treatment for a meningioma; this meningioma was strongly suspected as the cause of the recurrence.