A case of child fasciola liver abscess was reported. This case was a. A 5-years-old boy who had a history of fever and abdominal pain for 2 days. There was eosinophilia (15%) and an abdominal ultrasound demonstrated heterogenous hypoechoic mass in the liver. He was diagnosed with bacterial liver abscess and was treated with Unasyn, Amikin, Cefotaxime, and metronidazole. But, the fever did not subside completely and blood eosinophil count was increased to 50%. New hypoechoic lesion in the liver was revealed on the follow-up abdominal ultrasound. Liver biopsy was done and it revealed eosinophil infiltration. Also, there was eosinophil infiltration (20%) in his bone marrow. The serologic test for parasite-specific IgG antibody by micro-ELISA confirmed the diagnosis of Fasciola hepatica infection. He was successfully treated for two days with oral Triclabendazole, 15 mg/kg, daily. Blood eosinophil count was down to 10% and there was no abnormal lesion in the liver on abdominal ultrasound finding.
Abdominal Pain ; Amikacin ; Biopsy ; Bone Marrow ; Cefotaxime ; Child* ; Diagnosis ; Eosinophilia* ; Eosinophils ; Fasciola ; Fasciola hepatica ; Fascioliasis ; Fever ; Follow-Up Studies ; Humans ; Immunoglobulin G ; Liver Abscess* ; Liver* ; Male ; Metronidazole ; Serologic Tests ; Ultrasonography

PURPOSE: The aim of this study was to show the clinical importance of each parameter of esophageal pH-metry regarding age distribution. Also, the study was done to compare the reliability of each parameter in diagnosing gastroesophageal reflux disease (GERD). METHODS: A retrospective study, based on hospital discharge registry, was conducted among 30 children who were given 24hr esophageal pH monitoring. The patients with GERD were divided into two groups i.e., group I, children under 12 months of age (24 patients), group II, children between 1-7 years of age (17 patients). We compared the clinical presentations between these two groups and analyzed each four parameters of 24hr pH monitoring. RESULTS: The study suggests that the parameter of 24hr pH monitoring with the highest effect on total score was reflux index common to both groups. In addition, comparing esophageal pH parameter, the number of the longest reflux episode according to body position, the upright positions were more associated with high total score in patients with GERD over 12 month of age. CONCLUSION: In interpretations of 24hr pH monitoring, taking each parameter and age into consideration is important. There is an inevitable overlap of data between normal and abnormal populations. Therefore, a further study with larger sample is required to establish the range of the physiologic and the pathologic GERD.
Age Distribution ; Child ; Esophageal pH Monitoring* ; Gastroesophageal Reflux* ; Humans ; Hydrogen-Ion Concentration ; Retrospective Studies

PURPOSE: This study is intended to investigate results of skin prick tests, family history, and diet pattern in patients under 2 years of age diagnosed with atopic dermatitis (AD). METHODS: A total of 82 AD patients and 53 controls participated in this study. They visited outpatient department of Pediatrics in Pundang Cha hospital from July 2002 to May 2003. Questionnaire survey about family allergy history, duration of breast feeding, time of first weaning, kinds of foods eaten from birth was performed. Skin prick tests were performed with food allergens that consisted of egg, milk, mixed bean, beef, pork, cod, mixed flour and D. f. as aeroallergen, histamine as positive control, normal saline as negative control. RESULTS: Egg (19.5%), milk (11.0%), D. f. (9.8%), cod (8.5%) were the common allergens in AD patients. Erythema and wheal size was 14.6 mm, 2.7 mm in AD patients and 8.5 mm, 1.6 mm in controls (P< 0.05). There was no significant effect of age on the skin reactivity to histamine. Odd ratio of atopy was 31.6 (95% CI: 4.2-240.3) and that of family history was 2.6 (95% CI: 1.3-5.2). The mean age of the start of weaning was 5.6 months in AD patients and 4.5 months in controls (P< 0.05). There were no significant differences in duration of breast feeding and the number of foods eaten from birth between AD patients and controls. CONCLUSION: Egg, milk, D. f., and cod were the common allergens in AD patients under 2 years of age. This means that it is necessary for AD patients to have proper guide for weaning diet and regulation of environment. Allergy history of parents has high relative risk and therefore the high risk infants require positive prophylactic counterplans for AD.
Allergens ; Breast Feeding ; Dermatitis, Atopic* ; Diet* ; Erythema ; Flour ; Food Hypersensitivity ; Histamine ; Humans ; Hypersensitivity ; Infant ; Milk ; Outpatients ; Ovum ; Parents ; Parturition ; Pediatrics ; Surveys and Questionnaires ; Skin ; Weaning

PURPOSE: Atopic dermatitis is the most common chronic inflammatory skin disease in children. However, the role of allergy in the pathogenesis of atopic dermatitis is still controversial. The purpose of this study is to investigate the effects of antigen sensitization and development of respiratory allergy disease on severity of atopic dermatitis. METHODS: 211 children with atopic dermatitis were monitored for 2-3 years and classified into three groups: mild, moderate, severe. The severity of atopic dermatitis was compared with antigen sensitization identified by MAST CLA Korea Panel and development of respiratory allergy disease; such as asthma and allergic rhinitis. RESULTS: The frequency of mild, moderate, severe atopic dermatitis was respectively, 38.4%, 33.6%, 28.0%. Food sensitization was significantly higher in patients under 4 years old and aeroallergen sensitization was higher in patients above 5 years old. There was a good correlation between the severity of atopic dermatitis and food sensitization but not in aeroallergen. There was no significant association the severity of atopic dermatitis and development of respiratory allergy disease. CONCLUSION: This result suggests that the sensitization to food allergen is associated with the severity of atopic dermatitis, but sensitization to aeroallergen and development of respiratory allergy disease are not correlated. The restriction of sensitized diets might be helpful in management of atopic dermatitis.
Asthma ; Child ; Child, Preschool ; Dermatitis, Atopic* ; Diet ; Humans ; Hypersensitivity* ; Korea ; Rhinitis ; Skin Diseases

PURPOSE: Glucocorticoids is the most effective therapy in the long-term control of asthma. It appears to reduce inflammation in asthmatic airways largely by inhibiting the action of transcription factors that regulate abnormal gene expression. But, the effect of the glucocorticoids on the bronchial hyperresponsiveness (BHR) is still controversial. The aim of this study is to investigate the effect of dexamethasone (DEX) on airway hyperresponsiveness and airway inflammation in Ovalbumin (OVA) -induced murine asthma model. METHODS: Female BALB/c mice were immunized with OVA and alum on day 0 and challenged intratracheally on days 8, 15, 18 and 21 with OVA. DEX, 1.5 mg/kg. And, they were administered 30 min after OVA challenges on day 15, 18 and 21 by intraperitoneal injection. BHR to methacholine measured 24 hours later after last OVA challenge and number of total leukocytes and eosinophils in the bronchoalveolar lavage fluid (BALF) was counted. Lung histomorphometry and measurement of total IgE concentration in the BALF were performed. RESULTS: Dexamethasone treatment did not change BHR to methacholine in this model. But it significantly reduced recruitment of leukocytes and eosinophils in the BALF. Eosinophilic inflammation and mucus plugging in lung tissues were significantly attenuated in the dexamethasone treated mice. Total IgE level in the BALF decreased by dexamethasone treatment. CONCLUSION: Dexamethasone treatment attenuates the eosinophilic inflammation but not the BHR in the murine asthma model. This study demonstrates the dissociation between airway eosinophilia and BHR by dexamethasone treatment.
Animals ; Asthma* ; Bronchoalveolar Lavage Fluid ; Dexamethasone* ; Eosinophilia ; Eosinophils ; Female ; Gene Expression ; Glucocorticoids ; Humans ; Immunoglobulin E ; Inflammation* ; Injections, Intraperitoneal ; Leukocytes ; Lung ; Methacholine Chloride ; Mice ; Mucus ; Ovalbumin ; Ovum ; Transcription Factors

No abstract available.
Animals ; Hypersensitivity* ; Lymphocytes* ; Mice*

Cryptococcosis is an infrequently recognized infection in children, particularly those who are immunocompetent. The disease is mainly caused by Cryptococcus neoformans, a fungal pathogen that primarily affects the central nervous system (CNS) and lungs. Most reports of children with cryptococcosis are of the CNS or disseminated infections among immunocompromised patients. This report is a case of a 3-year-old immunocompetent girl who presented with intermittent fever and cough; a large mass was found in the right infrahilar area on chest X-ray. Chest computed tomography revealed large conglomerated mediastinal lymph nodes caused by C. neoformans, which was confirmed by the polymerase chain reaction as well as a histological evaluation. The patient improved after a prolonged period of antifungal therapy. This is the only known report of mediastinal and pulmonary cryptococcosis in an immunocompetent child.
Central Nervous System ; Child ; Cryptococcosis ; Cryptococcus neoformans ; Fever ; Humans ; Immunocompromised Host ; Lung ; Lymph Nodes ; Mediastinum ; Polymerase Chain Reaction ; Preschool Child ; Thorax

Acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs), which reduce the production of prostaglandin by inhibiting cyclooxygenase (COX), are widely used in children as antipyretic, analgesic, or anti-inflammatory drugs. They are known to be a major cause of pediatric drug allergies, which are diagnosed by a drug provocation test. The mechanism comprises an immunoglobulin E- or T cell-mediated immune reaction or pseudoallergy caused by the inhibition of COX-1. The diagnosis of NSAIDs drug allergy requires a differential, because there is a high cross-reactivity between NSAIDs. In this study, oral provocation tests with ibuprofen, acetaminophen, diclofenac and celecoxib were carried out, and various types of NSAIDs and acetaminophen allergies were observed. Safe drugs were recommended for each patient according to the test results. We report four cases of NSAIDs and acetaminophen allergy and include the results of oral provocation tests.
Acetaminophen ; Anti-Inflammatory Agents, Non-Steroidal ; Child ; Diclofenac ; Drug Hypersensitivity ; Humans ; Hypersensitivity ; Ibuprofen ; Immunoglobulins ; Prostaglandin-Endoperoxide Synthases ; Pyrazoles ; Sulfonamides ; Celecoxib

PURPOSE: The purpose of this study was to compare clinical manifestations of human bocavirus (hBoV), respiratory syncytial virus (RSV), and human rhinovirus (hRV) in children with acute wheezing. METHODS: We retrospectively investigated 549 virus-positive throat swabs obtained between January 2006 and December 2008 from pediatric inpatients with acute respiratory tract disease at Kwangju Christian Hospital. Among them, 109 patients, who had lower respiratory tract infections with wheezing, were enrolled in this study. The medical records of patients with positive results were reviewed for clinical data. RESULTS: The mean age of the patients with RSV was 7.15 months, 15.66 months in those with hRV, and 15.04 months in those with hBoV. The mean fever duration and frequency of patients with fever was 2.43 days and 47.9% for RSV, 2.86 days and 51.7% for hRV, and 3.75 days and 69.6% for hBoV. The frequency of patients with acute otitis media was 20.8% in the RSV, 20.7% in the hRV, and 13.0% in the hBoV groups. The frequency of lung infiltration on chest X-ray was 12.5% in the RSV, 20.7% in the hRV, and 47.8% in the hBoV groups. CONCLUSION: We compared the clinical manifestations of respiratory viral infections in infants and children with wheezing. However, further surveillance will be necessary to clarify the clinical manifestations of the viruses.
Bocavirus ; Child ; Fever ; Human bocavirus ; Humans ; Infant ; Inpatients ; Korea ; Lung ; Medical Records ; Otitis Media ; Pharynx ; Respiratory Sounds ; Respiratory Syncytial Viruses ; Respiratory Tract Diseases ; Respiratory Tract Infections ; Retrospective Studies ; Rhinovirus ; Thorax

PURPOSE: We conducted this research to make an earlier diagnosis and identify better treatment for Kikuchi-Fujimoto disease (KFD) by comparing clinical findings with nonspecifically enlarged cervical lymph nodes in children. METHODS: Nineteen patients were diagnosed with KFD by tissue pathology from a fine needle aspiration biopsy and/or excisional biopsy and were compared with the clinical, radiological, and pathological findings of reactive hyperplasia. RESULTS: The average onset age of onset for patients with KFD was 11.8+/-3.61 years, and the male to female ratio was 1:1.1, whereas patients with reactive hyperplasia were 11.8+/-5.96 years, and the male to female ratio was 1.7:1. Patients with KFD suffered more from fever than patients with reactive hyperplasia (68% vs. 13%, P=0.002). Patients with KFD showed perinodal infiltration (P=0.001) and necrosis on computed tomography, whereas patients with reactive hyperplasia did not show any of these findings. Ultrasonographic findings were similar between the two study groups. In contrast, the histopathological examinations of biopsied cervical lymph nodes were enormously helpful for distinguishing the findings of KFD from those of patients with reactive hyperplasia. CONCLUSION: We recommend a histopathological examination to distinguish KFD from reactive hyperplasia in children with significantly enlarged cervical lymph nodes.
Age of Onset ; Biopsy ; Biopsy, Fine-Needle ; Child ; Discrimination (Psychology) ; Female ; Fever ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Hyperplasia ; Lymph Nodes ; Lymphadenitis ; Male ; Necrosis