• Pediatric Infection and Vaccine
• /
• v.18 no.1
• /
• pp.80-84
• /
• 2011

Empyema necessitatis refers to empyema that extends into the extrapleural space through a defect in the pleural surface. Tuberculous empyema necessitatis is a rare complication of tuberculosis. We experienced a 21-month-old boy with tuberculous empyema necessitatis with osteomyelitis in the right $7^{th}$ rib. He presented with a mass on the right lateral chest wall, which was soft and nontender, enlarging for one month. He also had mild fever. The plain radiograph of his chest revealed soft tissue swelling and calcified lymph node on the left axilla, and his PPD skin test was positive. CT scan of the chest showed empyema necessitatis at the right lower chest and upper abdominal walls with osteomyelitis of the right $7^{th}$ rib. He did not have concurrent pulmonary tuberculosis. Surgery was performed for diagnosis and treatment. In histopathologic findings, chronic granulomatous inflammation with caseation necrosis was shown and was positive for acid fast bacilli stain. In addition, M. tuberculosis complex was found as etiology by polymerase chain reaction. The patient has been treated with anti-tuberculous medication without any specific complication.

• Pediatric Infection and Vaccine
• /
• v.12 no.2
• /
• pp.149-156
• /
• 2005

Purpose : Acute septic arthritis and acute osteomyelitis are not rare diseases in pediatric population. But when the diagnosis is delayed or inappropriate treatments are given, permanent disabilities of joint or bone can be followed. We analysed clinical manifestations, laboratory findings, X-ray findings, causative microorganisms and antibiotic susceptibility results of the two diseases in children. Methods : During January 1992 and May 2002, we conducted a retrospective study of 103 children who were diagnosed as acute septic arthritis and acute osteomyelitis. We selected out 34 children who had positive culture results in the blood or involved sites. Results : 19 cases were diagnosed as acute septic arthritis and 15 cases were acute osteomyelitis. These diseases were most common in preschool children and next in neonates. Hip joints and tibia were the most common sites in each disease. X-ray findings showed abnormalities in 6 cases(36%) of acute septic arthritis and 7 cases(50%) of acute osteomyelitis on admission. The most common microorganism isolated from the involved sites was Staphylococcus aureus; 12 out of 14 cases in acute septic arthritis and 6 out of 13 cases in acute osteomyelitis. Conclusion : It is difficult to make a clear initial diagnosis of the two diseases. We could not find any differences between these two diseases on clinical manifestations such as fever, swelling, tenderness and limitation of movements in joint and bone. The most common microorganism was Staphylococcus aureus.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.35 no.1
• /
• pp.39-40
• /
• 2009

Maxillary sinusitis is an infectious disease which can arise from odontogenic etiology and a maxillary osteomyelitis can spread into the sinus and consequently develop maxillary sinusitis. In this case report, a mid eighty's lady was diagnosed as BRONJ with maxillary sinusitis as a complication. The patient was managed successfully in collaboration with a endocrinologist. Through serial follow-up of serum CTX, we could decide the timing of surgical intervention.

• Proceedings of the KACD Conference
• /
• 2001.05a
• /
• pp.252-252
• /
• 2001

;The Varicella zoster virus can cause two infectious diseases. The primary infection of this virus leads to Chicken pox and it goes into a latent period until it reveals itself again. When secondarily shown. it is called Herpes Zoster. Herpes Zoster can usually be seen between T-3 and L-2 of immunodepressant patients but in 13%. it is seen in the trigeminal nerve branch. During the predrominal stage. burning sensation, itching. and sharp pain can be experienced unilaterally where the nerve branch is distributed. Patients can also express tooth pain in this stage. After 2-4 days the acute stage begins with its characteristic unilateral macule showing vesicle formation. In this stage fever and fatigue can be experienced. Continuous pain even after the acute stage is called postherpetic neuralgia; deep pain and burning sensation can be expressed by the patient. The sequelae of this disease consists of rare osteomyelitis. necrosis of the jaws. or loss of teeth.teeth.

• The Korean Journal of Pain
• /
• v.22 no.2
• /
• pp.176-180
• /
• 2009

Cases of pyogenic spondylodiscitis are relatively rare diseases that concern 2-7% of total cases of osteomyelitis. Owing to the low frequency and initial nonspecific nature of signs and symptoms, diagnosis is often delayed up to 2-6 months. If the proper treatment is not established due to a diagnostic delay, there is a possibility of a serious neurologic deficit and spinal instability. We report two cases of infectious spondylodiscitis which were misdiagnosed as compression fracture and spinal stenosis respectively. They could be correctly diagnosed after MRI and laboratory test and under the recovery state after an antifungal and antibiotic medication. Special careful attention during the diagnostic procedure is a really important step considering the diagnostic delay and its resultant unsatisfactory outcome.

• Imaging Science in Dentistry
• /
• v.33 no.2
• /
• pp.121-125
• /
• 2003

Burkitt's lymphoma is a type of non-Hodgkin's lymphoma occurring predominantly in children. In some cases, the first manifest site is the jaw, and the disease may be misdiagnosed as an infectious disease. A case of a 12-year-old boy with a painful swelling on the right retromolar triangle area is presented. At the time of the first visit, it was misdiagnosed as an osteomyelitis. Included are several characteristics and differential diagnosis of this disease.

• Neonatal Medicine
• /
• v.25 no.4
• /
• pp.191-195
• /
• 2018

Leukocyte adhesion deficiency is a rare primary immunodeficiency and autosomal recessive disorder caused by a mutation in the gene encoding CD18, which is a constituent of leukocyte integrins. Clinical features usually begin with a delay in the separation of the umbilical cord in the neonatal period, and are characterized by marked leukocytosis with infection, delayed wound healing, and repeated bacterial and fungal infections. We experienced a case of leukocyte adhesion deficiency diagnosed in the neonatal period, in which a late preterm infant admitted to neonatal intensive care unit presented with a septic hip. Flow cytometry analysis of whole blood showed a decrease in the expression of CD11b/CD18. This is the first case of leukocyte adhesion deficiency with neonatal septic hip diagnosed in Korea.

• Journal of Korean Neurosurgical Society
• /
• v.56 no.1
• /
• pp.21-27
• /
• 2014

Objective : Infectious spinal disease is regarded as an infection by a specific organism that affects the vertebral body, intervertebral disc and adjacent perivertebral soft tissue. Its incidence seems to be increasing as a result of larger proportion of the older patients with chronic debilitating disease, the rise of intravenous drug abuser, and the increase in spinal procedure and surgery. In Korea, studies assessing infectious spinal disease are rare and have not been addressed in recent times. The objectives of this study are to describe the epidemiology of all kind of spinal infectious disease and their clinical and microbiological characteristics as well as to assess the diagnostic methodology and the parameters related to the outcomes. Methods : A retrospective study was performed in all infectious spinal disease cases presenting from January 2005 to April 2010 to three tertiary teaching hospitals within a city of 1.5 million in Korea. Patient demographics, risk factors, clinical features, and outcomes were assessed. Risk factors entailed the presence of diabetes, chronic renal failure, liver cirrhosis, immunosuppressants, remote infection, underlying malignancy and previous spinal surgery or procedure. We comparatively analyzed the results between the groups of pyogenic and tuberculous spinal infection. SPSS version 14 statistical software was used to perform the analyses of the data. The threshold for statistical significance was established at p<0.05. Results : Ninety-two cases fulfilled the inclusion criteria and were reviewed. Overall, patients of tuberculous spinal infection (TSI) and pyogenic spinal infection (PSI) entailed 20 (21.7%) and 72 (78.3%) cases, respectively. A previous spinal surgery or procedure was the most commonly noted risk factor (39.1%), followed by diabetes (15.2%). The occurrence of both pyogenic and tuberculous spondylitis was predominant in the lumbar spine. Discs are more easily invaded in PSI. At initial presentation, white cell blood count and C-reactive protein levels were higher in PSI compared to TSI (p<0.05). Etiological agents were identified in 53.3%, and the most effective method for identification of etiological agents was tissue culture (50.0%). Staphyococcus aureus was the most commonly isolated infective agent associated with pyogenic spondylitis, followed by E. coli. Surgical treatment was performed in 31.5% of pyogenic spondylitis and in 35.0% of tuberculous spondylitis cases. Conclusion : Many previous studies in Korea usually reported that tuberculous spondylitis is the predominant infection. However, in our study, the number of pyogenic infection was 3 times greater than that of tuberculous spinal disease. Etiological agents were identified in a half of all infectious spinal disease. For better outcomes, we should try to identify the causative microorganism before antibiotic therapy and make every effort to improve the result of culture and biopsy.

• Pediatric Infection and Vaccine
• /
• v.20 no.2
• /
• pp.63-70
• /
• 2013

Purpose : This study aimed to explore how prevalent the community-related methicillin-resistant Staphylococcus aureus (CA-MRSA) was in children with muscular-skeletal infections. Methods : We retrospectively reviewed the medical records of patients of 18 years or under who were diagnosed with suppurative arthritis or osteomyelitis and S. aureus from September 2000 through August 2012 at the CHA Bundang Medical center. Results : Thirty-one cases of suppurative arthritis or osteomyelitis were identified. The patients were between 17 days old and 18 years old with an average age of 7. Eleven cases (33.5%) of suppurative arthritis and 16 cases (51.6%) of osteomyelitis were observed. Five cases were accompanied by the two diseases. Methicillin sensitive S. aureus (MSSA) was isolated in 25 cases (80.6%) and methicillin resistant S. aureus (MRSA) was isolated in 6 cases (19.4%). Multidrug resistant strains were not observed. MRSA was not found from 2000 through 2005. All patients were treated with antibiotics and the duration of antibiotics treatment was $26.4{\pm}12.7$ days. Vancomycin was used as the initial antibiotic treatment in 4 cases (12.9%) and vancomycin was used as the definitive antibiotics in the 10 cases (32.3%). Conclusions : The result of this study showed that methicillin resistance rate of S. aureus from muscular-skeletal infections was concentrated in the latter half of the 12 year period.

• Pediatric Infection and Vaccine
• /
• v.13 no.2
• /
• pp.174-179
• /
• 2006

Tuberculosis still ranks as one of the three most important infectious diseases in the world in terms of morbidity and mortality. In Korea, an increased incidence of tuberculosis has been observed in recent years. With the resurge of tuberculosis, extrapulmonary tuberculosis has increased, too. From this point of view, tuberculous arthritis affecting knee is rare in all forms of tuberculosis, but we can consider tuberculous arthritis in patients with osteomyelitis. We report the case of a 14-month-old male child who presented with fever and swelling on the left knee joint. Histologic examination of knee joint fluid showed consistent with tuberculosis. Ziehl-Neelsen stain of joint fluid was positive for acid-fast bacilli(AFB). The outcome was favorable after treatment with anti-tuberculosis medication. Because clinical signs and symptoms of musculoskeletal tuberculosis in children is more indolent, we can misdiagnose or delay diagnosis. The diagnosis of tuberculous arthritis can be elusive, necessitating a high index of suspicion.