• Pediatric Infection and Vaccine
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• v.5 no.2
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• pp.302-307
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• 1998

Hemolytic anemia due to cold agglutinin disease is a known complication of Mycoplasma pneumoniae infection but is rarely observed, particularly in children. A case of Mycoplasma pneumonia complicated with hemolytic anemia is presented. A 7 year-old girl was adimitted because of fever, cough, sputum and pale appearance. Chest X-ray showed pneumonic consolidation of Rt. upper lobe, lingular division. Laboratory studies disclosed the following values : Hb 5.3g/dL, Hct 11.1%, reticulocyte 2.9%, indirect Coombs test negative, direct Coombs test(monovalent) Anti-C3d positive, Anti-IgG negative, Anti-IgM negative, cold agglutinin titer 1 : 256, mycoplasma antibody titer 1 : 640, total bilirubin 1.0mg/dL. Initial PBS before wanning showed agglutination of red blood cells. The diagnosis of cold agglutinin hemolytic anemia complicating mycoplasma pneumonia was made. And treatment with roxithromycin, prednisolone and avoiding cold exposure was initiated, and complete recovery ensued. We report a case of cold agglutinin hemolytic anemia complicating mycoplasma pneumonia in children.

• Pediatric Infection and Vaccine
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• v.24 no.3
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• pp.146-151
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• 2017

Purpose: We analyzed the risk factors affecting readmission of children with pneumonia. Methods: We retrospectively analyzed the medical records of pediatric patients admitted to the Department of Pediatrics at the Jeonju Presbyterian Medical Center from January 2007 to August 2016. We classified patients who were readmitted with pneumonia within 30 days of discharge as the readmission group and patients who were admitted with pneumonia for the first time as the first admission group. Results: Among 158 patients, the study (readmission) group included 82 patients and the control (first admission) group included 76 patients. Age, the percentage of segmented neutrophils and lymphocytes, the number of admissions in the last 12 months, the associated diseases (respiratory diseases such as asthma), and the affection of the right upper lung were analyzed as risk factors for readmission. However, based on a regression analysis, only age and associated diseases were found to be significant risk factors. The rate of readmission increased with younger age. When there were associated diseases, the rate of readmission also increased. Conclusions: Young age and associated diseases were significant risk factors for readmission for patients with pediatric pneumonia. When pediatric patients are admitted with pneumonia, if they are young and/or have associated diseases, a comprehensive approach is needed to reduce the rate of readmission with careful consideration of precise examination, treatment, timing of discharge, and follow-up.

• Pediatric Infection and Vaccine
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• v.20 no.2
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• pp.71-80
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• 2013

Objectives: Outbreaks of pneumonia caused by Mycoplasma pneumoniae (MP) occur every 3-4 years in Korea, most recently in 2011. The aim of our study was to determine the optimal time to perform indirect particle agglutination antibody assays to improve early diagnosis of MP pneumonia in children. Methods: A database of 206 pediatric patients treated for pneumonia at the Hanyang University Hospital from June to October 2011 was analyzed retrospectively for demographic characteristics and laboratory test results. Results: Among the 206 patients treated for pneumonia during the study period, there were 160 children (mean age, 5.44 years) diagnosed with MP pneumonia, who were studied further. The mean age of these MP pneumonia patients was 5.44 years. Antibody titers increased with increasing time between symptom onset and the collection of serum collection: MP titers were <1:640 for sera collected after 5.44 days and titers ${\geq}1:640$ for those collected after 8.58 days; P<0.001). Antibody titers were considered positive when they reached ${\geq}1:640$. In 42 MP pneumonia patients in whom there was a four-fold or greater increase in titer between successive serum samples, the optimal cut-off time-point for distinguishing between the initial and second titer groups was 7.5 days after the onset of symptoms (sensitivity, 90.5%; specificity, 92.9%). Conclusions: Negative MP antibody titers earlier than 8 days after the onset of symptoms in children with pneumonia may require repeating to confirm the diagnosis. This finding could optimize diagnosis and result in better therapeutic outcomes of MP pneumonia in children.

• Pediatric Infection and Vaccine
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• v.4 no.1
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• pp.167-173
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• 1997

Acute infectious mononucleosis, caused by Epstein-Barr virus(EBV), is a self limited lymphoproliferative illness that is common in adolescents and young adults. It shows many complications in multiple organ systems, but the hepatobiliary and the respiratory complication is uncommon. We report a case with thickened gallbladder wall and pneumonia as complications of acute infectious mononucleosis in a child. Also the related literature were reviewed. A 4 year old boy presented with a history of high fever, cough, and abdominal distension for 20days. Physical Examination revealed audible crackles in whole lung field and gross hepatomegaly. Chest X-ray showed pneumonia and liver function tests were abnormal. Ultrasonography and computed tomography revealed a thickened gallbladder wall and hepatosplenomegaly. The diagnosis of primary Epstein-Barr viral infection was eventually made by specific serologic tests. The patients's fever subsided 6 weeks later and pneumonia was recovered around this time. Liver function tests returned near normal 2 months later and ultrasonography of gallbladder was normal at this time.

• Pediatric Infection and Vaccine
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• v.5 no.2
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• pp.276-282
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• 1998

Staphylococcal pneumonia caused by staphylococcus aureus can be characterized by its severity and rapid progress as a bacterial infection. The disease shows a high mortality in younger patients, especially in infants unless early and appropriate treatment is carried out. Treatment can be made of medical method alone but in cases of surgical interventions are needed, immediate surgical methods such as closed or open drainage of pleural fluid, lobectomy and decortication should be followed with combination of medical therapy. The choice of antibiotic should be made by proper antibiotic sensitivities tests. For a methicillin sensitive S. areus(MSSA), the penicillase resistant penicillin would be the first choice and for a methicillin resistant S. aureus (MRSA), the glycopeptides such as vancomycin would be the first one. Other drugs can also be used if the bacterial agents show any sensitivities to these drugs. Commonly, the chest roentgenographic findings reveal infiltrations, empyema, pneumothorax, pleural effusion, atelectasis or pneumatoceles in staphylococcal pneumonia and this fact easily can lead the physicians to its diagnosis as soon as possible. We experienced 5 cases of staphylococcal pneumonia in infants, proven by through bacterial cultures and report them with brief review of the related literatures.

• The Journal of Pediatrics of Korean Medicine
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• v.17 no.1
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• pp.131-140
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• 2003

Introduction : Pneumonia is an inflammation of alveolus and pneumal parenchyma and it is one of common pediatric diseases. According to, pneumonia belongs to the Haesu(咳嗽), Chunsik(喘息), Phechng(肺脹), Pungon(風溫). Purpose : The purpose of this study is to find out whether Socheongryongtanggamibang has any effects on children with pneumonia. Method : The subjects are in regard to children with pneumonia who visited Dae Jeon Oriental Medicine Hospital from December 2002 to April 2003. The herbal medicine therapy are applied for one week. Result and Conclusion : After treatment, the symptoms (coughing, rhinorrhea, sputum, fever) of pneumonia were improved. More studies about the Oriental Medicine treatment and conception on pneumonia are needed.

• Pediatric Infection and Vaccine
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• v.6 no.1
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• pp.131-135
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• 1999

Respiratory Syncytial Virus(RSV) causes acute respiratory tract infections in young infancy such as bronchiolitis, pneumonia. RSV infections are uncommon in the first month of life. Clinical manifestations of neonatal RSV infection are respiratory symptoms, apnea and bacterial sepsis like illness such as lethargy, poor feeding, fever, rash. We report a case of neonatal pneumonia caused by RSV and accompanied by transient apnea and favorable clinical outcome.

• Clinical and Experimental Pediatrics
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• v.52 no.3
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• pp.283-288
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• 2009

Pneumonia remains the leading cause of mortality in children. Diagnosis depends on a combination of factors, including clinical assessment, radiological and laboratory findings. Although Streptococcus pneumoniae remains the most important cause of childhood bacterial pneumonia, the great majority of cases of community-acquired pneumonia (CAP) are of viral etiology. A new, rapid, and inexpensive test that differentiates viral from bacterial pneumonia is needed to decide empiric antibiotic treatment. Antibiotics effective against the expected bacterial pathogens should be instituted where necessary. The role of emerging pathogens and the effect of pneumococcal resistance and heptavalent conjugate pneumococcal vaccines are to be considered in practice. There are reports supporting the valid and highly efficacious use of penicillin as a first-line drug for treating CAP. This review raises the issue of the overuse of unnecessary antibiotics in viral CAPs and the use of second or third-line antibiotics for non-complicated pneumonias in most clinical settings.

• Pediatric Infection and Vaccine
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• v.4 no.2
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• pp.271-275
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• 1997

We experienced a case of Henoch-Sch$\ddot{o}$nlein purpura associated with Mycoplasma pneumoniae pneumonia in a 28 month old male who suffered from cough, abdominal pain and both leg swelling and pain. Physical examination showed varying sized purpura, characteristic of Henoch-Sch$\ddot{o}$nlein purpura, below both knee. Laboratory test revealed Mycoplasma pneumoniae antibody titer >1:2,560 and cold agglutinins titer 1:64. Chest X-ray showed peribronchial blurring in both lung fields. The patient was treated with midecamycin and prednisolone for 7 days and responded to the treatment well. The authors report a case of Henoch-Sch$\ddot{o}$nlein purpura with Mycoplasma pneumoniae pneumonia with brief review of related literatures.

• Clinical and Experimental Pediatrics
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• v.54 no.8
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• pp.329-334
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• 2011

Purpose: The purpose of this article is to describe the clinical and epidemiologic features and outcomes among children hospitalized with pandemic influenza A/H1N1 2009 infection. Methods: We retrospectively reviewed the charts of hospitalized pediatric patients (<18 years) diagnosed with pandemic influenza A/H1N1 2009 infection by reverse-transcriptase polymerase chain reaction at a tertiary hospital in Seoul, Korea, between September 2009 and February 2010. Results: A total of 72 children were hospitalized with pandemic influenza A/H1N1 2009 infection (median age, 6.0 years; range, 2 months to 18 years). A total of 40% had at least 1 underlying medical condition, including asthma (17%), malignancies (19%), and heart diseases (17%). Of the 72 patients, 54 (76%) children admitted with H1N1 infection showed radiographic alterations compatible with pneumonia. There was no significant difference in pre-existing conditions between pandemic influenza A/H1N1 infected patients with or without pneumonia. Children with pandemic influenza A/H1N1 pneumonia were more likely to have a lower lymphocyte ratio (P=0.02), higher platelet count (P=0.02), and higher level of serum glucose (P=0.003), and more commonly presented with dyspnea than did those without pneumonia (P=0.04). Conclusions: No significant differences in age, sex, or presence of preexisting conditions were found between children hospitalized with pandemic influenza A/H1N1 H1N1 influenza infection with pneumonia and those without pneumonia. Higher leukocyte count, higher glucose level, and a lower lymphocyte ratio were associated with the development of pandemic A/H1N1 2009 influenza pneumonia.