• Title/Summary/Keyword: early infection

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Clinical manifestations of BK virus infection in pediatric kidney transplant patients

  • Kwon, Yiyoung;Kim, Jeong Yeon;Lee, Yeonhee;Cho, Heeyeon
    • Clinical and Experimental Pediatrics
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    • v.62 no.11
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    • pp.422-427
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    • 2019
  • Background: Polyomavirus BK (BKV) infection is an important cause of graft loss in kidney transplant patients. Purpose: The purpose of this study was to evaluate clinical findings and risk factors for BKV in pediatric patients after kidney transplantation. Methods: This retrospective single-center study included 31 pediatric kidney transplant recipients from January 2002 to December 2017. Two patients received 2 transplantations during the study period, and each transplant was analyzed independently. Total number of cases is 33 cases with 31 patients. BKV infection was confirmed from blood samples via periodic quantitative polymerase chain reaction. Results: The mean age at kidney transplantation was 11.0±4.7 years, and the male-to-female ratio was 2.7:1. Three patients had a past medical history of high-dose chemotherapy and autologous stem-cell transplantation for solid tumors. Nine patients (27.3%) developed BKV infection. The median period from kidney transplantation to BKV detection in blood was 5.6 months. There was no statistically significant difference in estimated glomerular filtration rate between patients with and those without BKV infection. Among 9 patients with BKV viremia, 7 were treated by reducing their immunosuppressant dose, and BKV was cleared in 6 of these 7 patients. In the other 2 BKV-positive patients, viremia improved without immunosuppressant reduction. Conclusion: BKV infection is common in children with kidney transplantation and might not have affected short-term renal function in our patient sample due to early immunosuppressant reduction at the time of BKV detection.

Utility of Serum Procalcitonin for Diagnosis of Sepsis and Evaluation of Severity (혈청 프로칼시토닌(serum procalcitonin) 측정을 통한 패혈증 진단 및 중등도 평가의 유용성)

  • Park, Tae-Jin;Lim, Chae-Man;Koh, Youn-Suck;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.1
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    • pp.51-57
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    • 2011
  • Background: Early recognition and treatment of sepsis would improve patients' outcome. But it is difficult to distinguish between sepsis and non-infectious conditions in the acute phase of clinical deterioration. We studied serum level of procalcitonin (PCT) as a method to diagnose and to evaluate sepsis. Methods: Between 1 March 2009 and 30 September 2009, 178 patients had their serum PCT tested during their clinical deterioration in the medical intensive care unit. These laboratories were evaluated, on a retrospective basis. We classified their clinical status as non-infection, local infection, sepsis, severe sepsis, and septic shock. Then, we compared their clinical status with level of PCT. Results: The number of clinical status is as follows: 18 non-infection, 33 local infection, 39 sepsis, 26 severe sepsis, and 62 septic shock patients. PCT level of non-septic group (non-infection and local infection) and septic group (sepsis, severe sepsis, septic shock) was $0.36{\pm}0.57$ ng/mL and $18.09{\pm}36.53$ ng/mL (p<0.001), respectively. Area under the curve for diagnosis of sepsis using cut-off value of PCT >0.5 ng/mL was 0.841 (p<0.001). Level of PCT as clinical status was statistically different between severe sepsis and septic shock ($^*severe$ sepsis; $4.53{\pm}6.15$ ng/mL, $^*septic$ shock $34.26{\pm}47.10$ ng/mL, $^*p$ <0.001). Conclusion: Level of PCT at clinical deterioration showed diagnostic power for septic condition. The level of PCT was statistically different between severe sepsis and septic shock.

Fatal Clinical Course of Probable Invasive Pulmonary Aspergillosis with Influenza B Infection in an Immunocompetent Patient

  • Park, Dong Won;Yhi, Ji Young;Koo, Gunwoo;Jung, Sung Jun;Kwak, Hyun Jung;Moon, Ji-Yong;Kim, Sang-Heon;Kim, Tae Hyung;Sohn, Jang Won;Shin, Dong Ho;Park, Sung Soo;Yoon, Ho Joo
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.3
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    • pp.141-144
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    • 2014
  • Invasive pulmonary aspergillosis (IPA) is rarely reported in patients who have normal immune function. Recently, IPA risk was reported in nonimmunocompromised hosts, such as patients with chronic obstructive pulmonary disease and critically ill patients in intensive care units. Moreover, influenza infection is also believed to be associated with IPA among immunocompetent patients. However, most reports on IPA with influenza A infection, including pandemic influenza H1N1, and IPA associated with influenza B infection were scarcely reported. Here, we report probable IPA with a fatal clinical course in an immunocompetent patient with influenza B infection. We demonstrate IPA as a possible complication in immunocompetent patients with influenza B infection. Early clinical suspicion of IPA and timely antifungal therapy are required for better outcomes in such cases.

Cynomolgus Macaque Model for COVID-19 Delta Variant

  • Seung Ho Baek;Hanseul Oh;Bon-Sang Koo;Green Kim;Eun-Ha Hwang;Hoyin Jung;You Jung An;Jae-Hak Park;Jung Joo Hong
    • IMMUNE NETWORK
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    • v.22 no.6
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    • pp.48.1-48.13
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    • 2022
  • With the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants, which are randomly mutated, the dominant strains in regions are changing globally. The development of preclinical animal models is imperative to validate vaccines and therapeutics against SARS-CoV-2 variants. The objective of this study was to develop a non-human primate (NHP) model for SARS-CoV-2 Delta variant infection. Cynomolgus macaques infected with Delta variants showed infectious viruses and viral RNA in the upper (nasal and throat) and lower respiratory (lung) tracts during the acute phase of infection. After 3 days of infection, lesions consistent with diffuse alveolar damage were observed in the lungs. For cellular immune responses, all macaques displayed transient lymphopenia and neutrophilia in the early stages of infection. SARS-CoV-2 Delta variant spike protein-specific IgM, IgG, and IgA levels were significantly increased in the plasma of these animals 14 days after infection. This new NHP Delta variant infection model can be used for comparative analysis of the difference in severity between SARS-CoV-2 variants of concern and may be useful in the efficacy evaluation of vaccines and universal therapeutic drugs for mutations.

Dissemination of Conidiospores of Colletotrichum gloeosporioides, the Anthracnose of Persimmon and the Disease Development (감나무 탄저병균 Colletotrichum gloeosporioides의 분생포자 비산과 농가 포장에서 탄저병의 발생과정)

  • Kwon, Jin-Hyeuk;Park, Chang-Seuk
    • Research in Plant Disease
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    • v.10 no.4
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    • pp.272-278
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    • 2004
  • The disease development of Anthracnose of sweet persimmon in relation to release of conida of Colletotrichum gloeosporioides were observed in a farmer's field located in Jinju from 1998 to 2002. The conidia started to release from early April and reached maximum in June to late July. The amount of conidia production reduced drastically from early August. The number of conidia trapped was closely related to amount of precipitation at the same period and number of new infections on the emerging branches and young fruits in orchard. The conidia released during the April was not effected to disease occurrence of persimmon tree but the spores produced from inoculum source after early May significantly important to the infection of the pathogen on emerging branch and this infection was directly related to infections on young fruits. Consequently the early infections on the branches brought severe occurrence of Anthracnose in the orchard. Most of the infected fruits were dropped in unripe state. The earlier infection caused the earlier fruit drop. The rate of fruit drop was reached up to 84.1% in August when the disease was occurred severely. Anthracnose of sweet persimmon also occurred in market shelf and storage warehouse. The anthracnose fruits are presumed to be infected while in orchard. Because the symptom formed on the fruit was too tiny to eliminate, the infected fruits were involved in storage boxes and anthracnose gradually developed in storage condition. The rate of diseased fruit observed in Jinju area were 1.2 to 1.6%.

Expression Analysis of Lily Type Lectin Isotypes in the Rock Bream, Oplegnathus fasciatus: in the Tissue, Developmental Stage and Viral Infection

  • Lee, Young Mee;Yang, In Jung;Noh, Jae Koo;Kim, Hyun Chul;Park, Choul-Ji;Park, Jong-Won;Noh, Gyeong Eon;Kim, Woo-Jin;Kim, Kyung-Kil
    • Development and Reproduction
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    • v.20 no.4
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    • pp.297-304
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    • 2016
  • Lectins belong to the pattern-recognition receptors (PRRs) class and play important roles in the recognition and elimination of pathogens via the innate immune system. Recently, it was reported that lily-type lectin-1 is involved when a pathogen attacks in the early immune response of fish. However, this study is limited to information that the lectin is involved in the innate immune response against viral infection. In the present study, the lily-type lectin-2 and -3 of Oplegnathus fasciatus (OfLTL-2 and 3) have been presented to be included B-lectin domain and two D-mannose binding sites in the amino acid sequence that an important feature for the fundamental structure. To investigate the functional properties of OfLTLs, the tissue distribution in the healthy rock bream and temporal expression during early developmental stage analysis are performed using quantitative real-time PCR. OfLTL-2 and 3 are predominantly expressed in the liver and skin, but rarely expressed in other organ. Also, the transcripts of OfLTLs are not expressed during the early developmental stage but its transcripts are increased after immune-related organs which are fully formed. In the challenge experiment with RBIV (rock bream iridovirus), the expression of OfLTLs was increased much more strongly in the late response than the early, unlike previously known. These results suggest that OfLTLs are specifically expressed in the immune-related tissues when those organs are fully formed and it can be inferred that the more intensively involved in the second half to the virus infection.

CASE REPORT OF NECROTIZING FASCITIS ON THE CERVICOFACIAL AREA (경부에 발생한 의인성 괴사성 근막염의 증례)

  • Moon, Cheol;Lee, Dong-Keun;Sung, Gil-Hyun;Park, Kyung-Ok;Lee, Jae-Eun;Kwon, Hyuk-Do
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.1
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    • pp.104-111
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    • 1994
  • Necrotizing fascitis is a severe soft tissue infection characterized by extensive necrosis of superficial fascia, suppurative fascitis, vascular thrombosis, widespread undermining of surrounding tissues. Associated systemic problems are widespread undermining of surrounding tissues, Associated systemic problems are common, with chronic alcoholism and diabetes being most prominent. Most commonly this disease presents in the extremities, trunk, and perineum. Necrotizing fascitis of dental origing is rare and its fulminating clinical course is not well documented in the dental literature. The present report is a case of necrotizing fascitis following vital extirpation of the pulp in a patient with uncontrolled diabetes mellitus and liver cirrhosis. Originally throught to be caused by hemolytic streptococcus organism or stphylococcus aureus, advances in anaerobic culturing have shown it to be a synergistic bacterial infection involving aerobic and ovligate anaerobes. it is relatively rare in relatively rare in haea and neck regions. If it was not diagnosed and treated in early stages, necrotizing fascitis can be potentially fetal, with a mortality rate approaching 40%. It's treatment requires early recognition, prompt and aggressive surgical debriment and proper supportive cares, such as, antibiotic therapy, fluid resuscitation and correction of metabolic and electrolyte disorder, resolving of the underlying systemic disease. Recently, we experienced two cases of necrotizing fascitis in cervicofacial region, One patient was 60 years old male with uncontrolled Diabetes Mellitus and other patient was 48 years old with steroid therapy during 30 years. Local surgical wound healing was successful but, patients were died after admission, because of lung abscess, gastrointestinal bleeding, septic shock and respiration hold.

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Fungal Osteomyelitis of Temporomandibular Joint and Skull Base Caused by Chronic Otitis Media

  • Kim, Bok Eum;Park, Keun Jeong;Lee, Jung Eun;Park, YounJung;Kwon, Jeong-Seung;Kim, Seong-Taek;Choi, Jong-Hoon;Ahn, Hyung-Joon
    • Journal of Oral Medicine and Pain
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    • v.45 no.1
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    • pp.12-16
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    • 2020
  • Chronic otitis media (COM) is a chronic inflammatory disease which affects the middle ear, mastoid cavity. It presents hearing loss, ear pain, dizziness, headache, temporomandibular joint (TMJ) inflammation and intracranial complication. Intracranial complications such as skull base osteomyelitis (SBO) may occur secondary to COM due to transmission of infection by a number of possible routes. SBO is an uncommon condition with a significant morbidity and mortality if not treated in the early stages. We report a-67-year-old male patient with diabetes and untreated COM who presented atypical severe TMJ, periorbital and postmandibular pain. By computerized tomography (CT), magnetic resonance imaging (MRI) and whole body bone scan (WBBS), he was diagnosed with SBO spreading from untreated COM via infective arthritis of TMJ. Through this case, we suggest proper utilization of diagnostic imaging, especially CT or MRI for the early detection of SBO in the case of COM accompanying with the greater risk of infection developments such as diabetes.

Malignant Tumor Mistaken for Infection or Stress Fracture - 4 cases report - (감염이나 피로 골절로 오인된 악성 종양 - 4례 보고 -)

  • Han, Chung-Soo;Lee, Young-Ho;Ha, Jeong-Han
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.93-100
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    • 2003
  • Clinical outcome of malignant tumor heavily depends on early diagnosis and proper management of the patient. But it's very difficult to diagnose malignant tumor in early stage because of it's vague symptoms and inadequate evidences of malignancy in radiologic studies and biopsy. Malignant tumor mistaken for infection or fracture initially will undergo inadequate treatment and that will influence on it's prognosis. So it's very important to rule out the possibility of malignancy by repeated evaluation if it's diagnosis is not definite. We report 1 case of osteosarcoma initially mistaken for stress fracture and 3 cases of osteosarcoma, malignant lymphoma and Ewing's sarcoma initially mistaken for tuberculosis and review the literature.

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Diagnostic accuracy of urinary biomarkers in infants younger than 3 months with urinary tract infection

  • Jung, Nani;Byun, Hye Jin;Park, Jae Hyun;Kim, Joon Sik;Kim, Hae Won;Ha, Ji Yong
    • Clinical and Experimental Pediatrics
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    • v.61 no.1
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    • pp.24-29
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    • 2018
  • Purpose: The aim of this study was to evaluate the diagnostic accuracy of urinary biomarkers, such as neutrophil gelatinase-associated lipocalin (uNGAL) and ${\beta}-2$ microglobulin (uB2MG), in early detection of urinary tract infection (UTI) in infants aged <3 months with fever. Methods: A total of 422 infants aged <3 months (male:female=267:155; mean age, 56.4 days), who were admitted for fever, were retrospectively included in this study. We compared uNGAL and uB2MG between the UTI and non-UTI groups at the time of admission. The sensitivity, specificity, accuracy, and area under the curve (AUC) of uNGAL and uB2MG for use in diagnosing UTI were assessed. Results: Among 422 patients, 102 (24.2%) were diagnosed with UTI. Levels of uNGAL were higher in the UTI group than in the non-UTI group (366.6 ng/mL vs. 26.9 ng/mL, P<0.001). Levels of uB2MG were not different between the 2 groups. Multivariate analysis revealed that uNGAL was an independent predictive factor for UTI (P=0.033). The sensitivity, specificity, and accuracy were 90.2%, 92.5%, and 91.9% for uNGAL, and 48.0%, 43.8%, and 44.8% for uB2MG, respectively. AUC of uNGAL was 0.942 and that of uB2MG was 0.407. Conclusion: Accuracy of uNGAL in the diagnosis of UTI is high in febrile infants aged <3 months. uNGAL can help in the early diagnosis and treatment of UTI in infants.