PURPOSE: The aim of this study was to investigate the clinical characteristics and causative organisms of meningitis in the Daegu region and seek a useful tool for the early prediction of bacterial meningitis in children. METHODS: We retrospectively reviewed the medical records of 115 pediatric patients diagnosed with bacterial or aseptic meningitis at Yeungnam university hospital in Daegu from March 2012 to July 2013. We evaluated their clinical symptoms, laboratory findings, clinical courses, bacterial meningitis scores and complications. RESULTS: The subjects included 106 with aseptic meningitis and 9 with bacterial meningitis. At the time of visit, fever was the most frequent symptom, followed by headache, vomiting and neck stiffness. In cerebrospinal fluid (CSF) analysis, white blood cell (WBC) count were higher in the bacterial meningitis group (1423.8+/-1980.4 vs. 120.0+/-161.6 mg/dL). Mean CSF protein was 219.4+/-183.6 mg/dL in bacterial meningitis and 42.4+/-27.0 mg/dL in aseptic meningitis (P <0.001). Bacterial meningitis score (BMS) were higher in the group with bacterial meningitis. Abnormal radiological findings were found in 44% of the group with bacterial meningitis. CONCLUSION: Although the clinical features between the groups were similar, the CSF analysis revealed significant differences statistically. Furthermore, BMS could be helpful to predict bacterial meningitis in children. During the outbreak of aseptic meningitis, it might reduce unnecessary hospital admissions and antibiotic treatments.
Cerebrospinal Fluid ; Child ; Daegu ; Fever ; Headache ; Humans ; Leukocytes ; Medical Records ; Meningitis ; Meningitis, Aseptic* ; Meningitis, Bacterial ; Neck ; Retrospective Studies ; Vomiting

Objective: The increase in mortality in rheumatoid arthritis (RA) patients with interstitial lung disease (ILD) is well known. However, there are few studies on serum markers that can evaluate acute exacerbation or prognosis in RA-ILD patients. The purpose of this study was to identify the association between biomarkers and lung lesions in patients with RA-ILD. Methods: We analyzed 153 patients with serum samples in a prospective, multicenter cohort of Korean RA-ILD patients. The serum levels of biomarkers, matrix metalloproteinase (MMP-7), surfactant protein-D (SP-D), and Krebs von den Lungen-6 (KL-6) were measured and correlated with forced vital capacity (FVC), diffusing capacity for carbon monoxide (DLCO) and the results of computed tomography (CT). CT results were interpreted semi-quantitatively according to the extent of lung lesions (grade 1, 0%∼ 25%; grade 2, 26%∼50%; grade 3, 51%∼75%; grade 4, 76%∼100%). Results: MMP-7, SP-D, and KL-6 were negatively correlated with FVC (MMP-7, r=−0.267, p=0.001; SP-D, r=−0.250, p=0.002; KL-6, r=−0.223, p=0.006) and DLCO (MMP-7, r=−0.404, p＜0.001; SP-D, r=−0.286, p=0.001; KL-6, r=−0.226, p=0.007). In addition, MMP-7, SP-D, and KL-6 tended to increase with higher grades of lung lesions on CT (MMP-7, p=0.013; SP-D, p＜0.001; KL-6, p＜0.001). Conclusion MMP-7, SP-D, and KL-6 can be used to evaluate the functional and anatomical status of lung involvement in the RA-ILD patients.

Objective: The increase in mortality in rheumatoid arthritis (RA) patients with interstitial lung disease (ILD) is well known. However, there are few studies on serum markers that can evaluate acute exacerbation or prognosis in RA-ILD patients. The purpose of this study was to identify the association between biomarkers and lung lesions in patients with RA-ILD. Methods: We analyzed 153 patients with serum samples in a prospective, multicenter cohort of Korean RA-ILD patients. The serum levels of biomarkers, matrix metalloproteinase (MMP-7), surfactant protein-D (SP-D), and Krebs von den Lungen-6 (KL-6) were measured and correlated with forced vital capacity (FVC), diffusing capacity for carbon monoxide (DLCO) and the results of computed tomography (CT). CT results were interpreted semi-quantitatively according to the extent of lung lesions (grade 1, 0%∼ 25%; grade 2, 26%∼50%; grade 3, 51%∼75%; grade 4, 76%∼100%). Results: MMP-7, SP-D, and KL-6 were negatively correlated with FVC (MMP-7, r=−0.267, p=0.001; SP-D, r=−0.250, p=0.002; KL-6, r=−0.223, p=0.006) and DLCO (MMP-7, r=−0.404, p＜0.001; SP-D, r=−0.286, p=0.001; KL-6, r=−0.226, p=0.007). In addition, MMP-7, SP-D, and KL-6 tended to increase with higher grades of lung lesions on CT (MMP-7, p=0.013; SP-D, p＜0.001; KL-6, p＜0.001). Conclusion MMP-7, SP-D, and KL-6 can be used to evaluate the functional and anatomical status of lung involvement in the RA-ILD patients.