• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.13 no.1
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• pp.30-35
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• 2010

Purpose: Infectious ileocecitis is an infection confined to the ileocecal area and one of the most common causes of pediatric abdominal pain. This study was performed to demonstrate the clinical features of infectious ileocecitis in children. Methods: The medical records and radiologic findings of 37 patients with ileocecitis diagnosed by ultrasonography and/or computed tomography, who were admitted to Pusan National University Hospital from January 2004 and July 2008, were reviewed retrospectively. Viral gastroenteritis and secondary ileocecitis were excluded. Results: The mean age of the patients was 4.8${\pm}$3.4 years. One-half of the patients were preschool children. The chief complaint was abdominal pain (75.7%), diarrhea (10.8%), and vomiting (8.1%). Accompanying symptoms were fever (56.8%), vomiting (21.6%), and diarrhea (16.2%). The mean duration of abdominal pain, fever, diarrhea, and vomiting was 3.8${\pm}$2.1, 3.0${\pm}$1.9, 3.4${\pm}$1.9, and 2.4${\pm}$2.3 days, respectively. The frequency of diarrhea and vomiting was 5.8${\pm}$2.2 and 4.0${\pm}$2.8 per day, respectively. Diagnosis was made by abdominal ultrasonography in 22 patients (59.5%), abdominal CT in 2 patients (5.4%), and both modalities in 13 patients (35.1%). Besides the radiologic finding of thickening of the bowel wall, mesenteric lymphadenitis (59.5%), ascites (5.4%), and both mesenteric lymphadenitis and ascites (16.2%) were revealed. The mean duration of illness was 7.5${\pm}$5.0 days. There were no specific laboratory findings, and culture studies with stool or blood were negative. All of the patients recovered completely without specific treatment. Conclusion: Infectious ileocecitis has acute appendicitis-mimicking symptoms, but is self-limited within a few days, thus unnecessary treatment and work-up is avoided. However, distinguishing infectious ileocecitis from appendicitis, inflammatory bowel disease, and mesenteric lymphadenitis is important.

• Pediatric Infection and Vaccine
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• v.7 no.2
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• pp.211-217
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• 2000

Purpose : Salmonellosis including typhoid fever is still prevalent in Korea. Recently it has been reported that the incidence of salmonella gastroenteritis is increasing with a reduction of typhoid fever. We studied the clinical and laboratory features of salmonellosis. Methods : We evaluated the clinical records of 83 patients with salmonellosis who had been confirmed by stool culture from 1994 to 1999. Results : Annual incidence of salmonellosis showed an increasing tendency during recent 4 years. Seasonally, summer(45.8%) was the most prevalent, followed by fall(32.5%). Male to female ratio was 1.4 : 1. In age distribution, 64 cases(77.1%) were under 5 year-old, and 18 cases(21.7%) were younger than 1 year-old. Clinical features included diarrhea(96.4%), fever(91.6%), vomiting(49.4%), bloody stool(42.1%), abdominal pain(40.1%) and tenesmus(12.0%). In serogroups, there was no group A and group B, group C, group D(including 2 cases of S.typhi) and group E were in 41.0%(34 cases), 3.6%(3 csaes), 51.8%(43cases) and 3.6%(3 cases), respectively. In Widal test, 5 cases(13.5%) and 1 case(2.7%) of group B, C and E(total 37 cases) were observed the O titer above 1 : 80 and 1 : 320, respectively. However, in 36 cases of group D, 19 cases(52.7%) and 9 cases(25.0%) were above the O titer 1 : 80 and 1 : 320, respectively. Antibiotics resistant rates to ampicillin, trimethoprim/sulfamethoxazole and chloramphenicol were 23.2%, 10.1% and 51.4%, respectively. Conclusion : Salmonellosis has become a common cause of gastroenteritis in children, especially under the pre-school age. Isolation of salmonella is neccessary for accurate diagnosis of gastroenteritis and typhoid fever. A careful attention of the use of antibiotics is needed to reduce the muilti-drug resistant strains.

• Pediatric Infection and Vaccine
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• v.18 no.1
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• pp.40-47
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• 2011

Purpose : Norovirus infection, a common cause of community-acquired gastroenteritis, can also lead to severe illness in immunocompromised patients. We investigated clinical manifestations of norovirus infection in pediatric cancer patients. Methods : Stool specimens were collected from pediatric patients with gastrointestinal symptoms between November 2008 and September 2009 at Samsung Medical Center, Seoul, Korea. Norovirus infection was identified by reverse-transcription polymerase chain reaction (RT-PCR). A retrospective chart review was performed in pediatric cancer patients who were diagnosed with norovirus infection. Results : Ten patients were diagnosed with norovirus infection by RT-PCR in stool samples. The median age was 0.83 years (range 0.25-5.5 years) and the male to female ratio was 1.5:1 (6 males and 4 females). Underlying diseases were hematologic malignancies (4/10, 40%), neuroblastoma (4/10, 40%), and brain tumors (2/10, 20%). Three patients were infected before hematopoietic cell transplantation (HCT) and four patients after HCT. All patients had diarrhea (10/10, 100%), with a median frequency of diarrhea of 8.5 times/day (range 4-22 times/day). Median virus shedding duration was 72.5 days (range 19-299 days). Four patients with pneumatosis intestinalis were conservatively treated with bowel rest and total parenteral nutrition. One patient with severe diarrhea and bloody stool had concomitant chronic gut graft-versus-host disease (GVHD). Norovirus infection-related mortality was not observed. Conclusion : Norovirus infection can cause significant clinical manifestations with prolonged viral shedding in immunocompromised patients. Norovirus should be considered in pediatric cancer patients with severe gastrointestinal symptoms.

• Korean Journal of Veterinary Research
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• v.34 no.3
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• pp.517-527
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• 1994

An attempt was made to isolate a causative viral agents from the fecal specimens of the diseased dogs with the gastroenteritis symptoms. Two coronavirus-like agents were isolated by serial dilution end point method and plaque assay. The isolates were characterized in terms of cytopathology, antigenicity, replication, physicochemical and morphological properties. The results obtained through the experiment were as follows; 1. Among 7 fecal specimens collected from the dogs with enteric disease, 2(28.6%)coronavirus-like agents showing typical cytopathic effects of canine coronavirus were isolated, and designated as CCV D1 and CCV D2, respectively. 2. By the cross-neutralization test and indirect immunofluoresence antibody test, the isolates were antigenically indentified as the standard CCV. The viruses were replicated only in the cytoplasm of A-72 cells. 3. The isolates showed no haemagglutinating activity against the erythrocytes from 11 kinds of animals. 4. The electron microscopic observation for the isolates showed spherical and pleomorphic features, covered with club-shaped projections on the surface. The size of particles was ranged from 70 to 150nm. 5. In one-step growth curve for the isolates in A-72 cells, maximum titers of intracellular vius was $10^{4.6}$ $TCID_{50}/0.1ml$ at 46 hrs postinoculation(pi) of CCV Dl and $10^{4.4}$ $TCID_{50}/0.1ml$ at 34 hrs pi of CCV D2. The maximum titers of extracellular virus was $10^{5.5}$ $TCID_{50}/0.1ml$ at 58 hrs pi of CCV D1 and $10^{5.8}$ $TCID_{50}/0.1ml$ at 46 hrs pi of CCV D2. 6. In physicochemical property test, the isolates were very sensitive to choroform and were found to be RNA virus. The viruses was stable at pH 3.0 for 1 hr and at $22{^{\circ}C}$ for 5 hrs. However, infectivity titers reduced remarkably by treatment with $56{^{\circ}C}$ for 10min.

• Pediatric Infection and Vaccine
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• v.25 no.2
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• pp.61-71
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• 2018

Purpose: Research on the clinical role of Staphylococcus aureus as a pathogen in acute gastroenteritis (AGE) in children has been scarce. This study aimed to clarify the prevalence and clinical correlation of S. aureus detection in children with AGE. Methods: Fecal samples were collected from children with symptoms of AGE who visited a secondary hospital between January 2012 and December 2015. The samples were sent to the Seoul Metropolitan Government Research Institute of Public Health and Environment to test for pathogenic organisms. Clinical patterns were analyzed through medical record review. Results: Among the 663 participants, the bacteria detection rate was 26.2% (n=174), the virus detection rate was 29.7% (n=197), and the non-detection rate was 43.1% (n=286). S. aureus was tested positive from 102 cases and was confirmed as a single pathogen in 53 cases. It was the third most common pathogen. The prevalence by age was highest (45.3%) in 0-2 year-olds. Most cases occurred in summer. Symptoms included diarrhea (71.7%), vomiting (67.9%), fever (49.1%), and abdominal pain (37.7%). Only vomiting showed a significant difference between the S. aureus group and the non-detection group (67.9% vs. 43.0%; P=0.001). Among enterotoxins, the higher incidence of vomiting was associated with classical staphylococcal enterotoxins (SEA, SEB, SEC, SED, and SEE) and SEH (P=0.027). Conclusions: S. aureus was the bacteria commonly isolated from children with AGE. Our study identified cases of staphylococcal AGE in children based on fecal samples and confirmed the characteristic symptoms, affected age groups, seasonal distribution, and correlation with enterotoxins.

• Pediatric Infection and Vaccine
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• v.15 no.2
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• pp.121-128
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• 2008

Purpose : The seasonality of influenza virus and rotavirus are well recognized in winter and so viral surveillance and laboratory-based diagnostics are important to guide the timing of prophylaxis and other interventions. Yet the seasonality of these two viruses are changing in Korea. We evaluated the prevalence and clinical features of influenza virus and rotavirus. Methods : From September 2001 to August 2005, nasopharyngeal aspirates were cultured from the hospitalized patients with lower respiratory infections and the stools from hospitalized patients with gastroenteritis were tested for rotavirus. We retrospectively analysed the medical records. Results : During the study period, respiratory virus was isolated in 578 (18.5%) out of 3,121 patients. Influenza virus was isolated in 143 cases. The seasonal distribution of influenza infection was from December to June of the next year. The ratio of males to females was 1.3:1 and the median age was 17 months. The most common diagnosis of influenza infection was bronchiolitis. Fever and cough were present in 94.4% and 83.9% of the patients, respectively. During the same period, 3,850 patients were admitted for gastroenteritis and 1,047 (27%) patients were positive for rotavirus. Rotavirus was prevailed from December to June of the next year and it presented in year-round. The ratio of males to females was 1.1:1 and the median age was 16 months. Diarrhea and vomiting were the most common symptoms. Conclusion : The recent peak prevalence of influenza virus and rotavirus in Korea was in winter and the late spring, respectively. So we need to expand surveillance and carefully consider the correct period to vaccinate people.

• Journal of Environmental Health Sciences
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• v.46 no.5
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• pp.525-531
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• 2020

Objectives: This study was performed to identify the epidemiological features of a food poisoning outbreak in a company cafeteria located in Chungcheongnam-do Province, Korea in June of 2020 and to suggest preventive measures for a similar incidence. Methods: A total of 84 patients with acute gastroenteritis were examined. Environmental samples were obtained from 16 food handlers, six food utensils, 135 preserved foods served over three days and nine menus, and six drinking water samples. These are analyzed to detect viruses and bacteria. Results: Ninety-four out of the 402 people who were served meals (23.4%) predominantly showed symptoms of diarrhea, and the number was over 3 times. Among the 84 patients under investigation, 17 cases (20.2%) were positive for Enteropathogenic E. coli (EPEC) and 18 cases were positive for Clostridium (C.) perfringens (21.4%). Based on the investigation, it was concluded that the main pathogens were EPEC and C. perfringens. For EPEC, it was detected in three of the food service employees and in the preserved food and curry rice. The results of pulsed field gel electrophoresis indicate that all EPEC cases are closely related except for one food service employee. Assuming that isolated EPEC originated from the preserved food, the incubation period is about 25 hours. The origin of the C. perfringens was not determined as it was not detected in the food service employees or environmental samples. Conclusions: This case suggests that food provided in group food service centers must be thoroughly managed. In addition, identifying the pathogens in preserved food is very important for tracing the causes of food poisoning, so food must be preserved in an appropriate condition. To prevent similar food poisoning cases, analyzing cases based on epidemiological investigation and sharing the results is needed.

• The Journal of Korean Society of Virology
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• v.29 no.4
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• pp.247-259
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• 1999

Small round structured viruses (SRSV) are the major ethological agents which can cause outbreaks of non-bacterial gastroenteritis or food poisoning both in children and adults. The classification of family Caliciviridae to which SRSV belong, is based on the genome encoding three open reading frames. The rotavirus is another major pathogen which causes diarrhea in young children. We examined stool specimens obtained from diarrheal patients in Wonju from which bacterial pathogens were not found. To detect causative viruses from stool specimens of patients, reverse transcription (RT)-polymerase chain reaction (PCR) or nested PCR using rotavirus or SRSV specific primers was performed. In this study, RT-nested PCR procedure which can amplify a 330 bp fragment derived from RNA dependent RNA polymerase (RDRP) region within ORF1 was applied for the detection of SRSV. For the detection of rotaviruses, a 877 bp fragment from the VP4 region of rotavirus genome was amplified. As a result, rotavirus was not detected while SRSV sequences were detected from one out of five specimens. The nucleotide and amino acid sequences of the Wonju isolate were compared with other 6 Korean isolates which have been isolated and sequenced in our laboratory. Sequence analysis revealed that the Wonju isolate was rather distinct from other Korean isolates: the Wonju isolate was closer to genogroup I of SRSV while other 6 Korean isolates belonged to genogroup II.

• Korean Journal of Veterinary Research
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• v.40 no.1
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• pp.173-186
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• 2000

This experiment was carried out to investigate the tendency of incident diseases in pre- and post- weaning piglets which ages were 1 to 7 weeks old by laboratory diagnosis and in order to minimize death in preweaning piglets and of stunted growth in postweaning piglets. The result of this experiment used as the basic data for the preventive programs in pre- and post- weaning piglets and were as follows: 23 different diseases diagnosed in 331 cases were studied in relation to age, season, and etiology. The most prevelent diseases of pre- and post- weaning piglet were Colibacillosis(79 case, 23.9%) and the major diseases were Salmonellosis(44 cases, 13.3%), Anemia(37 cases, 11.2%). Unknown viral disease(20 case, 6.1%), Rota viral infection(19 case, 5.8%), Porcine reproductive & respiratory syndrome(PRRS; 15 case 4.5%), Transmissible gastroenteritis(TGE; 12 case, 3.6%). The gastrointestinal disease, such as Colibacillosis, Salmonellosis, Swine dysentery, Clostridial infection, Rotaviral infection, TGE, Porcine epidemic diarrhea(PED) and Ballantidiosis occured pro- dominently in the period of pre- and post- weaning, which were 178 cases(53.8%) and not related to occurrence according to age and season. The respiratory diseases were Atrophic rhinitis(AR), Swine enzootic pneumonia, Pneumonic pasteurellosis, Pleuropneumonia, Branchopneumonia, PRRS and which were 48 cases(14.5%) and higher prevalent in spring and summer. The viral diseases was 73 cases(22.1%) that occurred in the period of 5 weeks piglet and prevalent mainly in spring. The bacterial diseases were 188 cases(56.8%) that were not related to occurrence according to age and season. Salmonellosis was prevalent in 3 to 5 weeks piglet and mainly occurred in summer. Viral septicemia and rotaviral infection occurred after 5 weeks piglets intensively and 3 to 5 weeks, respectively. And the both occurred without relation with season. PRRS occurred after 4 weeks piglet and prevalent in summer. TGE occurred 1 to 7 days old piglets and prevalent in spring and winter. Hematologic values of anemia was decrease in number of Red Blood Cell, concentration of Hemoglobin and Hematocrit. Amikacin, cephalothin, colistin, norfloxacin were effective to E coli, and amikacin, cephalothin, nortloxacin, neomycin were effective to Salmonellra spp. but clindamycin, erythromycin, penicillin, sulfonamides were resistant to E coli and Salmonella spp.

• Korean Journal of Microbiology
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• v.49 no.3
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• pp.228-236
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• 2013

Campylobacter jejuni is one of important food-borne pathogens causing human gastroenteritis. We isolated 42 strains of C. jejuni from diarrhea patients and 4 food-poisoning outbreaks in 2010, Gyeonggi-do. In this study, 42 strains were tested for genetic characteristics, the serotype distribution and antimicrobial resistant rate. The presence of hipO (100%), cdtB (100%), and mutated gyrA (95.2%) genes was detected in C. jejuni by polymerase chain reaction (PCR). Detection of mutated gyrA gene correlated with ciprofloxacin resistance. Forty isolates had mutated gyrA gene and were actually resistant to ciprofloxacin. Furthermore, comparing the gyrA DNA sequence data, ciprofloxacin-resistant isolates had a mutation of the DNA sequence from ACA (threonine) to ATA (isoleucine). But 41 strains (97.6%) of patient isolates were susceptible to erythromycin and azithromycin. A total of 35.7% among 42 C. jejuni isolates were identified into 4 different serotypes. The serotype distribution of C. jejuni strains were shown to be HS2(B), HS3(C), HS4(D), HS19(O). To investigate the genotypes of C. jejuni isolated in Gyeonggi province, repetitive sequence polymerase chain reaction (rep-PCR) analysis and SmaI-digested pulsed-filed gel electrophoresis (PFGE) profile analysis were performed. From the PFGE analysis of 42 C. jejuni strains, 12 clusters of PFGE profile were obtained. On the other hand, 11 clusters of rep-PCR profile were obtained from 42 strains of C. jejuni.