• Pediatric Infection and Vaccine
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• v.8 no.2
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• pp.253-259
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• 2001

Kikuchi's disease(histiocytic necrotizing lymphadenitis) is characterized by lymphadenopathy in young patients below 30 years old, and persistent fever, lymphopenia and splenomegaly are concomitantly developed in many cases. So, it has been confused with lymphoma, SLE, and tuberculosis, and has easily led to inappropriate diagnostic procedures and administration of drugs. Many reports have indicated that Kikuchi's disease should be added to the list of causes of FUO in the setting of lymphadenopathy, and recommended early lymph node biopsy to distinguish from lymphoma, SLE, and tuberculosis to avoid unnecessary treatments. We experienced a case of subacute necrotizing lymphadenitis in a 14-year-old boy who presented with persistent high fever, productive coughing and cervical lymphadenopathy for about 1 month. Initially, diagnostic workup was done to look for the causes of FUO in vain. Finally, we confirmed diagnosis by histopathological findings of lymph node biopsy and detected latent gene of EBV in the biopsied specimen using in situ hybridization.

• Clinical and Experimental Pediatrics
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• v.49 no.12
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• pp.1282-1286
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• 2006

Purpose : The causes of prolonged fever have changed during the years and are influenced by age, geographic location and availability of diagnostic facilities/techniques. The aim of the present study was to determine the causes of prolonged fever, to know the proportion and outcomes of undiagnosed children. Methods : We reviewed patients with fever persisting for more than 2 weeks in duration, with documented temperatures of $38^{\circ}C$ on several occasions, or uncertain diagnosis after intensive study of 1 week duration in other hospitals who were admitted to Pusan National University Hospital during the period from July 1999 to June 2004. Results : Fifty-four (59.0 percent) were boys and thirty-seven (41 percent) were girls. Forty-six cases were less than 6 years and 45 cases were more than 6 years; the mean age was $6.48{\pm}6.56years$. In 62 cases (68.1 percent), the fever had persisted for 2 to 3 weeks before admission and in 26 cases (28.6 percent), had lasted longer than a month. Final diagnosis had been reached in 66 of 91 children (72.5 percent). The most common cause was infection (38/91), followed by collagen vascular disease (12/91), immune deficiency (3/91), neoplasia (2/91), and miscellaneous disease. Tuberculosis was the most common infectious cause. The causes of fever were not revealed in 25 cases. Outcome on discharge were as follows; 77 cases (84.6 percent) were improved, 10 cases (11.0 percent) discharged without improvement and 4 cases (4.4 percent) expired. Conclusion : The most common cause of prolonged fever in Korean children remains infection, but the incidence of infection was decreased as compared with previous studies. Tuberculosis is the most common among infectious causes. As Kikuchi disease (subacute necrotizing lymphadenitis) represented a significant cause of prolonged fever, it should be considered if a patient has neutropenia with lymphadenopathy. Undiagnosed patients with prolonged fever (27.5 percent) have increased over previous studies.

• Journal of Korean Academy of Nursing
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• v.16 no.2
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• pp.70-76
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• 1986

This study was aimed to observe the incidences and types of hospital infections and to compare the length of hospitalization and of the operation between the infected Patients and those of non-infected after the operations. The subject of study were 465 patients who had been operated surgically in a University Hospital from March 1 to April 30, 1985. The data were collected by reviewing medical charts of subjects. The criteria to diagnose hospital infection for this study had been revised the one utilized at University of Virginia Hospital in the U.S. Summary of the results were as follows: 1. The incidence rate of hospital infection was 6 %. The type of infection with higher incidence rate in order were wound infection(28.5%）urinary infection(28.5%), fever of unknown origin (25%) and septicemia (18%). 2. There was a statistically significant difference in the duration of hospitalization between the patient group without it (t=265.2, p<0.005). 3. There was a statistically significant difference in the duration of operation between the patient group with it (t=75.0, p<0.005).

• Korean Journal of Bronchoesophagology
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• v.4 no.1
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• pp.127-131
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• 1998

Histiocytic necrotizing lymphadenitis(NHL), or Kikuchi-Fujimoto disease, is of unknown origin that causes persistently enlarged cervical lymph nodes unresponsive to antibiotic therapy, usually in young women. Symptoms of NHL include tender cervical adenopathy, fever, weight loss, and night sweats. Laboratory studies usually reveal leukopenia and increased erythrocyte sedimentation rate. Lymph node biopsy reveals areas with frank cell necrosis, karyorrhexis, and absence of plasma cells. NHL follows a benign course, but shoud be differentiated from other diseases such as inflammatory, granulmomatous and malignant lymphadenopathies. We describe . three cases of NHL with a review of the literature.

• Pediatric Infection and Vaccine
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• v.28 no.3
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• pp.160-167
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• 2021

Pyogenic spondylitis, an extremely rare complication of nontyphoidal Salmonella infection in immunocompetent children, occurs more commonly in patients with hemoglobinopathies such as sickle cell disease or in immunocompromised patients. In this study, we report a case of pyogenic spondylitis in a previously healthy 13-year-old immunocompetent adolescent, who presented with prolonged fever and right upper quadrant pain. Stool culture results comfirmed nontyphoidal Salmonella infection, and the patient was diagnosed with pyogenic spondylitis caused by nontyphoidal Salmonella based on additional imaging studies performed for evaluation of the patient's prolonged fever. This case highlights the importance of culture studies for evaluation of patients with fever of unknown origin and also the importance of detailed investigations for early detection of complications of extra-intestinal infections in patients with an unusual clinical course of salmonellosis.

• Childhood Kidney Diseases
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• v.26 no.2
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• pp.107-110
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• 2022

Nephrogenic diabetes insipidus, decreased ability to concentrate urine, with production of large amounts of urine, is caused by the refractory response of renal tubules to the action of antidiuretic hormone. This rare disorder, known as X-linked nephrogenic diabetes insipidus, is caused by a mutation in the AVPR2 gene. Because it is hereditary, most patients are male. This report highlights a case of nephrogenic diabetes insipidus in a 3-year 5-month-old female; upon presentation to the hospital, her symptoms included frequent urinationand consumptionof a significant amount ofwater,which had begun2 years ago. The results of blood tests showed increased levels of serum antidiuretic hormone, and sellar magnetic resonance imaging showed no abnormality. The results of the water restriction test and the desmopressin administration test confirmed the diagnosis of nephrogenic diabetes insipidus showing a partial response to desmopressin. The results of genetic testing indicated the presence of an AVPR2 mutation, a heterozygous missense mutation (p.Val88Met), suggesting inheritance of X-linked nephrogenic diabetes insipidus. This report describes a significant case of symptomaticX-linked nephrogenic diabetes insipidus in a female patient who showed a partial response to desmopressin.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1993.05a
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• pp.110-110
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• 1993

Necrotizing lymphadenitis, or Kikuchi's disease, a newly recognized disease of unknown origin, occurred usually in young woman and mostly resolved spontaneously without treatment within a few months. Clinically, characteristic symptoms and sings were local lymph node enlargement, sometimes accompanied by tenderness, fever, weightless, leukopenia, and elevated erythrocyte sedimentation rate, and so necrotizing lymphadenitis can be confused with malignant lymphoma and tuberculosis. The histologic features of necrotizing lymphadenitis are distinctive. : lymph node biopsy reveals areas with frank cellular necrosis, karyorrhexis, and absence of plasma cell. We present nineteen cases of necrotizing lymphadenitis during from March 1990 to January 1993 and discuss their exact diagnosis and proper treatment.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.1
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• pp.56-59
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• 2008

Extrahepatic portosystemic shunts, known as Abernethy malformations, were first reported by John Abernethy in 1793. They are classified into two types: Type I refers to a congenital absence of the portal vein and Type II refers to a shunt involving a side-to-side anastomosis with reduced portal blood flow into the liver parenchyma. This malformation is so rare that less than 100 cases have been reported in the medical literature. We report the case of a 13-month-old boy who had a congenital extrahepatic portocaval shunt with a hypoplastic portal vein. This case was complicated with an atrial septal defect and a large hyperplastic nodule in the liver. The patient was diagnosed with a Type II Abernethy malformation. We planned on surgical occlusion of the extrahepatic portocaval shunt. However, six months later, the patient had a sudden onset of a fever of unknown origin and developed hepatic encephalopathy. Although he underwent a liver transplantation, he died of acute hepatic failure.

• Journal of Korean Neurosurgical Society
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• v.49 no.1
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• pp.43-48
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• 2011

Objective: Classical markers of infection cannot differentiate reliably between inflammation and infection after neurosurgery. This study investigated the dynamics of serum procalcitonin (PCT) in patients who had elective spine surgeries without complications. Methods: Participants were 103 patients (47 women, 56 men) who underwent elective spinal surgery. Clinical variables relevant to the study included age, sex, medical history, body mass index (BMI), site and type of surgery, and surgery duration. Clinical and laboratory data were body temperature, white blood cell count (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and PCT, all measured preoperatively and postoperatively on days 1, 3, and 5. Results: PCT concentrations remained at <0.25 ng/mL during the postoperative course except in 2 patients. PCT concentrations did not correlate with age, sex, DM, hypertension, BMI, operation time, operation site, or use of instrumentation. In contrast, CRP concentrations were significantly higher with older age, male, DM, hypertension, longer operation time, cervical operation, and use of instrumentation. Conclusion: PCT may be useful in the diagnosing neurosurgical patients with postoperative fever of unknown origin.

• Clinical and Experimental Pediatrics
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• v.52 no.2
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• pp.247-250
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• 2009

Stevens-Johnson syndrome (SJS) presents with widespread blisters, erythematous or purpuric macules, and one or more mucous membrane erosions. Various etiologic factors, including infection, vaccination, drug administration, systemic diseases, physical agents, and food have been implicated as causes of SJS. Mycoplasma pneumoniae is the most common infectious agent to cause SJS in children. In recent literature, M. pneumoniae-induced SJS with mucositis that lacks the typical target lesions has been described. We report a case of a 6-year-old boy with swelling, peeling of the lips, and red eyes with photosensitivity. On physical examination, he showed severe oral mucositis and conjunctivitis with no evidence of skin lesions. Mycoplasma antibody, which was positive with titers of more than 1:2,560. For patients presenting with fever and mucositis of unknown origin, M. pneumoniae should be considered.