No abstract available.
Azithromycin* ; Pregnancy* ; Scrub Typhus*

The Korean hemorrhagic fever (KHF) is an acute febrile disease with characteristic of fever, bleeding tendency, and renal failure. There are many complications of Korean hemorrhagic fever such as infection, anemia, internal bleeding, hypopituitarism, respiratory, and neurologic complication. A few cases were reported on acute pancreatitis with hemorrhagic fever abroad, but there was no case about Korean hemorrhagic fever with acute pancreatitis in this country. We experienced a case of Korean hemorrhagic fever associated with suspected acute pancreatits. With review of articles, we report a case of 51 year-old woman with KHF, where acute pancreatitis developed during management.
Anemia ; Female ; Fever ; Hantavirus ; Hemorrhage ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Hypopituitarism ; Middle Aged ; Pancreatitis* ; Renal Insufficiency

No abstract available.
Mastoid* ; Mastoiditis* ; Otitis Media* ; Otitis* ; Sinus Thrombosis, Intracranial*

Klebsiella pneumoniae infection has a tendency of abscess formation and it is known to be associated with diabetes mellitus. In Taiwan, over the past 15 years, K. pneumoniae has emerged as the leading pathogen of liver abscess especially in diabetic patients. Although metastatic infection was a characteristic feature of K. pneumoniae liver abscess and bacteremia, metastatic soft tissue infection was extremely rare and only 6 cases have been reported in the world so far. Recently, we experienced a case of K. pneumoniae liver abscess with bacteremia and multiple metastatic infections including endophthalmitis, pyelonephritis, empyema, psoas abscess with retroperitoneal abscess, and soft tissue abscess at buttock and thigh in a 51-year-old male patient with diabetes. Also, a case of K. pnuemoniae liver abscess complicated with multiple metastatic infections will be additionally introduced. Here we report two cases of K. pneumoniae liver abscess with multiple septic metastatic lesions and the data we have reviewed.
Abscess ; Bacteremia ; Buttocks ; Diabetes Mellitus* ; Empyema ; Endophthalmitis ; Humans ; Klebsiella pneumoniae* ; Klebsiella* ; Liver Abscess* ; Liver* ; Male ; Middle Aged ; Pneumonia ; Psoas Abscess ; Pyelonephritis ; Soft Tissue Infections ; Taiwan ; Thigh

Bacterial esophagitis is an uncommon disease and has not been well characterized. Bacterial infection of the esophagus is usually presented as a superimposed infection upon a preexisting viral or fungal esophagitis and most patients are immunocompromised hosts. A 67-year-old man was admitted for retrosternal pain and hematemesis, who had a past history of long-standing diabetes mellitus and end stage renal disease, also had a history of steroid medication. Extensive esophageal ulcerations of the mucosa were visualized by endoscopy. Staphylococcus aureus grew in blood culture. After the 2 weeks of antibiotics treatment, he was successfully recovered without any sequelae. Due to its rarity, this case is herein reported with a review of the corresponding literature.
Aged ; Anti-Bacterial Agents ; Bacterial Infections ; Diabetes Mellitus ; Endoscopy ; Esophagitis* ; Esophagus ; Hematemesis ; Humans ; Immunocompromised Host* ; Kidney Failure, Chronic ; Mucous Membrane ; Staphylococcus aureus ; Ulcer

Malaria remains one of the most important infectious diseases in the world. For those not immuned to malaria, delayed diagnosis and treatment have been associated with an increase in morbidity and mortality, and development of severe complications. Pulmonary edema is one of the serious complications in falciparum malaria. It usually occurs in association with cerebral malaria, acute renal failure, high parasitemia, and delayed antimalarial treatment, as well as treatment-related side effects. We report two cases of severe falciparum malaria with rapidly developed pulmonary edema, which was not combined with cardiac decompensation or fluid overload. Both patients had a history of traveling to foreign countries, Thailand and Ghana, which chloroquine-resistant malaria is distributed. The first patient who developed hyperbilirubinemia, hypoglycemia, thrombocytopenia, decreased mentality, multi-organ failure, and pulmonary edema with acute respitatory distress syndrome, was treated with quinine, doxycycline, hemodialysis, and mechanical ventilation. The patient was recovered with a sequela of restrictive lung change. The second patient also developed anemia, thrombocytopenia, mental confusion, and pulmonary edema with aucte lung injury. Through the treatment of quinine, diuretics, and high concentration of oxygen via facial mask, the patient was successfully recovered without any sequela.
Acute Kidney Injury ; Anemia ; Communicable Diseases ; Delayed Diagnosis ; Diuretics ; Doxycycline ; Ghana ; Humans ; Hyperbilirubinemia ; Hypoglycemia ; Lung ; Lung Injury ; Malaria ; Malaria, Cerebral ; Malaria, Falciparum* ; Masks ; Mortality ; Oxygen ; Parasitemia ; Plasmodium falciparum* ; Plasmodium* ; Pulmonary Edema ; Quinine ; Renal Dialysis ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult* ; Thailand ; Thrombocytopenia

The spinal cord is a commonly affected site in human immunodeficiency virus (HIV) infection. Even though the most common disease of the spinal cord is vacuolar myelopathy, there is no case report yet in Korea. We experienced a case of suspicious vacuolar myelopathy in a 33 year-old male patient with acquired immunodeficiency syndrome. The patient presented with progressive paraparesis, gait disturbance, urinary difficulty, and the loss of sensation below thoracic spine 6~7 dermatome. Cerebrospinal fluid showed mild pleocytosis, increased protein level, and normal glucose content. The spine MRI showed extensive ill defined areas of increased signal intensity through the visualized lower cervical and thoracic spinal cord. Steroid therapy with antiretroviral drugs appeared to be ineffective to improve the symptoms of the patient.
Acquired Immunodeficiency Syndrome* ; Adult ; Cerebrospinal Fluid ; Gait ; Glucose ; HIV ; Humans ; Korea ; Leukocytosis ; Magnetic Resonance Imaging ; Male ; Paraparesis ; Sensation ; Spinal Cord ; Spinal Cord Diseases* ; Spine

Pylephlebitis is defined as an inflammation of the portal system, which is a rare but dreaded complication of intra-abdominal inflammatory processes. In the past it was observed as a sequela of neglected or complicated appendicitis. With earlier diagnosis, modern surgical technique and antibiotics, the incidence has declined even further. In addition, thrombosis in portal system (pylethrombosis) can complicate the pylephlebitis, followed by obstruction of the portal system, leading to portal hypertension in the late stage. Proper recognition of early thrombosis and an accompanying intra-abdominal inflammatory process should arouse the suspicion of septic thrombophlebitis and lead to the early institution of adequate therapy to prevent the almost universally fatal outcome. We report the case of woman who had pylephlebitis and presented with fever of unknown origin, probably associated with acute appendicitis.
Anti-Bacterial Agents ; Appendicitis ; Diagnosis ; Fatal Outcome ; Female ; Fever of Unknown Origin* ; Fever* ; Humans ; Hypertension, Portal ; Incidence ; Inflammation ; Portal System ; Portal Vein* ; Thrombophlebitis* ; Thrombosis

BACKGROUND: The aim of this study was to monitor trends in antimicrobial susceptibilities of Neisseria gonorrhoeae isolates, in particular, to examine the possibility of increasing prevalence of fluoroquinolone resistance in Korea and the relationship between patterns of mutations involving gyrA and parC genes and the ciprofloxacin resistance level. METHODS: The antimicrobial susceptibilities of 489 gonoccocal isolates which were nationwide collected from patients visiting Health Centers were determined by NCCLS disk diffusion and agar plate dilution methods. PCR and direct DNA sequencing of the amplicons were performed to identify mutations within the quinolone resistance-determining regions of gyrA and parC genes. RESULTS: The proportion of resistance to penicillin, tetracycline, or both remained as high as 94%. The isolates with ciprofloxacin resistance remarkably increased from 1% in 1999 to 5% in 2000 and also resistance to cefoxitine and ceftriaxone were shown to be increased. The strains resistant to spectinomycin was little reported. Four isolates with 16 microgram/mL of MIC for ciprofloxacin all showed the same alternations of Ser-91 to Phe, Asp-95 to Gly in GyrA and Ser-87 to Arg in ParC, but ciprofloxacin-susceptible strains have little amino acid substitution. CONCLUSION: Considering the increasing prevalence of isolates with resistance to ciprofloxacin and ofloxacin, it is likely that the antibiotics such as spectinomycin, or ceftriaxone are recommended as the first-line treatment for gonoccocal infections in Korea. The results from this study suggest that mutation analysis for quinolone resistance-determining regions of gyrA and parC genes are important in epidemiological studies for the spread of ciprofloxacin resistant strains.
Agar ; Amino Acid Substitution ; Anti-Bacterial Agents ; Cefoxitin ; Ceftriaxone ; Ciprofloxacin ; Diffusion ; Humans ; Korea* ; Neisseria gonorrhoeae* ; Neisseria* ; Ofloxacin ; Penicillins ; Polymerase Chain Reaction ; Prevalence ; Sequence Analysis, DNA ; Spectinomycin ; Tetracycline

BACKGROUND: Although the incidence of hepatitis A infection has dramatically declined in developed countries, it is still endemic in many of developing countries, and sporadic outbreak has developed in many middle classed endemic area. Many reports indicate that hepatitis A vaccine would have to be used for widespread immunization of infants, who live in endemic or non-endemic region, for eliminating this infection from circulation. Therefor, the optimal immunization schedule and dose of vaccine should be determined. Recent several studies suggested that high dose hepatitis A vaccination at the time of disappearance of maternal antibody promise protectable immunogenicity in infants. The purpose of our study to find out the prevalence and persistence of maternal HAV antibodies in Korean infants (below 2 years old age). METHODS: 60 mother without past-history of hepatitis A, and 300 heathy infants without history of hepatitis A vaccination and intra-familial contact history of hepatitis A were enrolled in this study. The infants below 2 years old age were classified into 5 groups as following; 0~3 months, 4~6 months, 7~9 months, 10~12 months, 13~24 months, and the number of each group were 60 and sex distribution of each group was equal. Positive rates of Anti-HAV were determined by ELISA. And comparisons of seroprevalence of anti- HAV between groups were analyzed by ANOVA repeated t-test. RESULTS: The seropositive rate of maternal group was 81.7%, and the seropositive rate of 0~3 months of age group was 43.3%. The seroprevalence of anti- HAV significantly declined after 4~6 months of age, and reached below 10% at the age of 7~9 months of age and the low rate of anti-HAV maintained until 2 years old age. And positive rates of anti-HAV showed no significant differences between males and females. CONCLUSION: The results of our study showed that the seroprevalence of anti-HAV significantly declined after 4~6 months of age and the anti-HAV almostly disappeared at 7~9 months of age. So, low seropositive rate of anti-HAV at 7 months of age may justify trials on infant vaccination in Korea.
Antibodies ; Child, Preschool ; Developed Countries ; Developing Countries ; Enzyme-Linked Immunosorbent Assay ; Female ; Hepatitis A ; Hepatitis A Antibodies ; Hepatitis A Vaccines ; Hepatitis* ; Humans ; Immunization ; Immunization Schedule ; Incidence ; Infant* ; Korea ; Male ; Mothers ; Prevalence* ; Seroepidemiologic Studies ; Sex Distribution ; Vaccination