Genotype ; Humans ; Streptococcal Infections ; diagnosis ; microbiology ; Streptococcus agalactiae ; genetics

A 5-week-old male child was admitted to Tabubil Hospital with a rapidly progressive, fulminating right-sided empyema which necessitated thoracotomy and drainage. The causative organism was a haemolytic Streptococcus.
Acute Disease ; Combined Modality - Therapy ; Empyema - diagnosis ; Infant ; Male ; Streptococcal Infections - diagnosis*

PURPOSE: Measurement of antistreptolysin O (ASO) is often necessary to confirm a clinical diagnosis of recent streptococcal infection, especially in patients suspected of rheumatic fever and acute glomerulonephritis. Standard normal ranges for ASO should be established locally for each age group. We analyzed ASO to determine the upper limit of normal (ULN) ASO in children in the Gyeonggi-Incheon area. METHODS: ASO in normal individual concentrations were measured quantitatively by nephelometry on sera from 753 children (Male:381, Female:372). ULN were determined by separating the upper 20% from the lower 80% of the group (80 percentile). RESULTS: The mean ASO concentration calculated in a total cases was 149.9+/-7.2 IU/mL. The ASO concentration in neonates was 83.4+/-10.7 IU/mL, and lowest in the 1 year of age group, 26.7+/-6.6 IU/ mL, and increased to 318.0+/-33.2 IU/mL gradually in the 9 years of age group. Thereafter, ASO concentration decreased. The ULN for neonates was 122 IU/mL, for 0-3 years, 40 IU/mL; for 4-6 years, 113 IU/ mL; for 7-9 years, 489 IU/mL; for 10-19 years, 433 IU/mL; for 20-29 years, 122 IU/mL. CONCLUSION: The age-specific ULN for children in the Gyeonggi-Incheon area were determined. The distribution of ASO concentration according to age groups was different from previous reports. These results should be of clinical value to physicians to interprete the ASO results of their patients.
Antistreptolysin* ; Child* ; Diagnosis ; Glomerulonephritis ; Humans ; Infant, Newborn ; Nephelometry and Turbidimetry ; Pediatrics ; Reference Values ; Rheumatic Fever ; Streptococcal Infections

Female urethral diverticulum is an uncommon entity but being diagnosed with increasing frequency according to improvement of diagnostic maneuver and increment of general awareness of the condition. Herein we reviewed 6 cases of female urethral diverticulum. Common presentations were dysuria, pus per urethra, frequency and postvoid dribbling. Variable sized masses were palpable on periurethral anterior vaginal wall Streptococcal infection. 2 diverticula were revealed in radiologic studies. Excision of diverticulum was performed in all patients. Intraoperatively urethral injury was made in 3 patients, among them 2 patients had no complication but one patient developed urethrovaginal fistula and urinary incontinence which did not disappear in 6 month follow-up. For the diagnosis of female urethral diverticulum, the most important thing is the high index of suspicion prior to many diagnostic tools.
Diagnosis ; Diverticulum* ; Dysuria ; Female* ; Fistula ; Follow-Up Studies ; Humans ; Streptococcal Infections ; Suppuration ; Urethra ; Urinary Incontinence

Streptococcal toxic shock syndrome with myonecrosis is a rapidly progressive process that kills 80% of patients in 72-96 h. Various bullae, hypotension, fever, and evidence of organ failure are late clinical manifestations. The symptoms and signs of myonecrosis can be nonspecific and misleading, not clearly revealing the involvement of deep skeletal muscle. Thus, the challenge to clinicians is to make an early diagnosis and to intervene with aggressive fluid replacement, emergent surgical debridement, and general supportive measures. We describe an presentation of myonecrosis of the lower extremities secondary to group A beta-hemolytic streptococcus infection in a 21-years-old woman. In addition, the patient had no history or evidence of trauma to the affected area.
Debridement ; Early Diagnosis ; Female ; Fever ; Humans ; Hypotension ; Lower Extremity ; Muscle, Skeletal ; Shock, Septic* ; Streptococcal Infections ; Streptococcus*

Humans ; Young Adult ; Fusobacterium necrophorum ; Pharyngitis/microbiology* ; Streptococcal Infections ; Sepsis/diagnosis*

Poststreptococcal glomerulonephritis (PSGN) is one of the most well-known and important infectious renal diseases resulting from a prior infection with group A beta-hemolytic streptococcus. The typical clinical characteristics of the disease reflect acute onset with gross hematuria, edema, hypertension and moderate proteinuria after the antecedent streptococcal infection. In children, usually PSGN is healed spontaneously but if it combines with fast progressing glomerulonephritis, it would be developed to chronic renal failure. Therefore, it is important to make a fast diagnosis and treatment by simple tools to predict the course and the prognosis of disease. Sonography is a simple tool for diagnosis but there is no typical renal sonographic finding in PSGN, so it is difficult to predict the course and the prognosis of disease by sonographic findings. In comparison between two cases of renal sonographic findings in PSGN, a patient who showed more increased echogenicity in more extended area of renal sonography had the severe results of renal pathology, prolonged treatment period and low serum C3 level. Here, we report the different findings of renal sonography and pathology depending on the degree of severity between two patients. Thus, it is necessary to gather more information from further studies to make a consensus about the relationship between the renal sonography and the prognosis of disease in PSGN.
Child ; Consensus ; Diagnosis ; Edema ; Glomerulonephritis* ; Hematuria ; Humans ; Hypertension ; Kidney Failure, Chronic ; Pathology ; Prognosis ; Proteinuria ; Streptococcal Infections ; Streptococcus ; Ultrasonography

PURPOSE: This study aimed to compare the clinical outcome of acute poststreptocaccal glomerulonephritis (APSGN) between patients who had presented with gross hematuria and those with microscopic hematuria. METHODS: Thirty-nine patients with acute poststreptococcal glomerulonephritis, who were diagnosed from January 2000 to April 2003 were enrolled. RESULTS: The mean age was 8.85 years and the male to female ratio was 1.1:1. Seventeen patients presented with gross hematuria at diagnosis(group A) and twenty-two patients had microscopic hematuria only(group B). There were no significant differences between the two groups in the incidence of edema, fever or history of respiratory infection and oliguria. But hypertension was more frequent in group B. Laboratory data showed decreased C3 and C4 level in group B. Spot urine protein/creatinine ratio and 24hr urine protein showed higher levels in group A. CONCLUSION: Patients with gross hematuria at diagnosis had lower incidence of hypertension and a higher rate of nephrotic range of proteinuria than patients with microscopic hematuria. However, no difference in the duration of admission or complication rate was observed. All patients had clinical improvement during follow-up. We conclude that gross hematuria is not a significant prognostic factor for poststreptococcal glomerulonephritis.
Diagnosis ; Edema ; Female ; Fever ; Follow-Up Studies ; Glomerulonephritis* ; Hematuria* ; Humans ; Hypertension ; Incidence ; Male ; Oliguria ; Proteinuria ; Streptococcal Infections

BACKGROUND AND OBJECTIVES: Abscess of neck is a life-threatening disease in children. Detection of abscess is important because it is essential for the determination of surgical drainage. However, clinical diagnosis is difficult, because children are seldom able to verbalize their symptoms or cooperate with physical examination. This study aims to review the clinical characteristics of 157 pediatric patients with neck inflammation and investigate the relative risk factors for abscess. SUBJECTS AND METHOD: Pediatric patients who were admitted to Dongguk University Hospital from January 2005 to July 2014 with acute neck inflammation were reviewed. All 157 pediatric patients were divided into two groups, based on radiologic findings with and without neck abscess. RESULTS: Of 157 patients, 53 children were diagnosed with neck abscess, and peritonsillar abscess was the most common type of neck abscess followed by submandibular abscess, retro·parapharyngeal abscess and posterior triangle & other abscess. The dominant pathogens, staphylococcal infection (≤2 yr) and streptococcal infection (>3 yr), was different for the different age group. The abscess group except for peritonsillar abscess was characterized by younger age, higher heart rate and WBC count, and longer hospital days than those without abscess (p=0.026, 0.026, <0.001, 0.007 respectively). Multivariate analysis revealed younger age (≤24 mo) and higher heart rate were independent predictors for abscess formation (odds ratio: 3.022, 2.923). CONCLUSION: Pediatric patients with high heart rate & younger age are at risk for abscess formation; meticulous care and early imaging work up are required in younger children with deep neck infection, and especially with higher heart rate.
Abscess* ; Child ; Diagnosis ; Drainage ; Heart Rate ; Humans ; Inflammation ; Methods ; Multivariate Analysis ; Neck* ; Peritonsillar Abscess ; Physical Examination ; Risk Factors ; Staphylococcal Infections ; Streptococcal Infections

We describe the first case of primary peritonitis in Korea of a healthy person due to Streptococcus pyogenes. In the absence of comorbid conditions, such as liver cirrhosis, immunosuppression, or nephrotic syndrome, primary peritonitis is uncommon in a young healthy woman. Abdomen computed tomography revealed ascites in the lower abdomen and peritoneal enhancement suggesting peritonitis. In diagnostic laparoscopy, purulent ascites was found in the pelvic cavity but both ovaries and fallopian tubes were intact. There were no intra-abdominal abnormalities such as bowel perforation, appendicitis, or necrosis. The reports of blood culture, ascites culture, and cervical swab culture confirmed S. pyogenes. After use of antibiotics, the patient was cured and discharged without sequelae.
Adult ; Anti-Bacterial Agents/therapeutic use ; Female ; Humans ; Laparoscopy ; Peritonitis/*diagnosis/drug therapy/microbiology ; Streptococcal Infections/*diagnosis/drug therapy/microbiology ; Streptococcus pyogenes/*isolation & purification ; Tomography, X-Ray Computed