No abstract available.

BACKGROUND: Although malaria-specific antibody or antigen test is useful for the diagnosis of malaria infection, its cost-effectiveness has to be concerned in the area where malaria prevalence is very low. We created a panel test composed of malaria non-specific parameters, namely hematology autoanalyzer-derived results with or without addition of HDL-cholesterol data, and evaluated its usefulness in comparison with malaria-specific antibody test. METHODS: For 395 patients tested for malaria smear, the hematology parameters such as platelet count, NRBC (%) and VCS (volume, conductivity, scattering) parameters of WBC, and HDL-cholesterol data were analyzed. Statistical significance of each parameter and that of panel test with or without addition of HDL-cholesterol were evaluated. RESULTS: Malaria antibody test showed sensitivity of 97.1% and specificity of 99.1%. Each parameter of platelet count, NRBC (%), D parameter and HDL-cholesterol showed sensitivity of 86.8%, 41.2%, 81.8%, and 70.6%, and specificity of 85.9%, 96.3%, 72.3%, and 81.7%, respectively. Panel test without including HDL-cholesterol showed sensitivity of 91.2% and specificity of 81.6%, and that including HDL-cholesterol showed sensitivity of 91.2% and specificity of 86.2%. CONCLUSIONS: The malaria non-specific panel test composed of hematology autoanalyzer-derived parameters showed relatively good, but slightly lower sensitivity than that of malaria-specific antibody test. It might be used as a screening test for the diagnosis of malaria infection, and addition of HDL cholesterol improved little the usefulness of the panel test.
Animals ; Autoanalysis ; Biological Markers ; Cholesterol, HDL/*blood ; Diagnosis, Differential ; Hematologic Tests/economics/utilization ; Humans ; Malaria, Falciparum/blood/*diagnosis ; Plasmodium falciparum/isolation & purification ; ROC Curve ; Reagent Kits, Diagnostic ; Sensitivity and Specificity

Gemellae is a gram positive cocci that forms part of the oropharyngeal microflora in humans and is anaerobic to aerotolerant. Unlike the other members of the same genus, G. morbillorum rarely causes human infections. Recently, we experienced a case of tubo-ovarian abscess caused by G. morbillorum which was initially suspected to be actinomycosis associated with intrauterine device. This is the first case in the world on tubo-ovarian abscess with G. morbillorum as the culprit.
Abscess ; Actinomycosis ; Gemella ; Gram-Positive Cocci ; Humans ; Intrauterine Devices

Gemellae is a gram positive cocci that forms part of the oropharyngeal microflora in humans and is anaerobic to aerotolerant. Unlike the other members of the same genus, G. morbillorum rarely causes human infections. Recently, we experienced a case of tubo-ovarian abscess caused by G. morbillorum which was initially suspected to be actinomycosis associated with intrauterine device. This is the first case in the world on tubo-ovarian abscess with G. morbillorum as the culprit.
Abscess ; Actinomycosis ; Gemella ; Gram-Positive Cocci ; Humans ; Intrauterine Devices

Cerebral mycotic aneurysm is an uncommon complication of infective endocarditis. In spite of low incidence, mycotic aneurysm is a serious complication because of the high risk of its rupture. Therefore, early diagnosis and management of cerebral mycotic aneurysm are imperative before the rupture. We experienced a case of asymptomatic cerebral mycotic aneurysm in a 30-year old man with infective endocarditis. He was admitted for splenic and renal infarction due to systemic embolization. The echocardiography showed severe mitral regurgitation, mitral valve prolapse and vegetation on the mitral valve. Streptococcus mitis was identified from blood cultures. In the course of antibiotics therapy, brain magnetic resonance image and 4-vessel cerebral angiography were performed, which revealed multiple unruptured cerebral mycotic aneurysms. Considering the high risk of rupture we performed mitral valve replacement with bioprosthesis. On follow-up cerebral angiography after the valve replacement surgery, one of aneurysms was enlarged, and successfully treated by surgical intervention without complication. We report one case of mycotic aneurysm without neurologic symptom in an infective endocarditis patient, who was treated without serious sequelae of the aneurysm.
Adult ; Aneurysm ; Aneurysm, Infected* ; Anti-Bacterial Agents ; Bioprosthesis ; Brain ; Cerebral Angiography ; Early Diagnosis ; Echocardiography ; Endocarditis* ; Follow-Up Studies ; Humans ; Incidence ; Infarction ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Prolapse ; Neurologic Manifestations ; Rupture ; Streptococcus mitis

PURPOSE: Acute pyelonephritis (APN) is among the most common infectious diseases. Most APN occurs in young women and easily treated. Bacteremia has been associated in approximately 20-30% of those with APN. But recent documents demonstrated that blood cultures provide no useful information toward the clinical management of acute pyelonephritis. Thus we compared demographic and clinical characteristics as related to the bacteremic status, and investigated the risk factors for bacteremia. METHODS: One hundred sixty five patients, who visited myongji hospital for APN from January, 2004 to December, 2006 were included. Retrospective data were analyzed by medical record review. RESULTS: Bacteremic patients (N=51, 30.9%) were significantly older than those in nonbacteremic group (p<0.0001), had elevated serum creatinine (p=0.008), decreased platelet counts (p=0.029), lower serum protein (p=0.010), and lower serum albumin (p=0.011) than those without bacteremia. Hematuria was more severe in bacteremic patients (p<0.0001). The bacteremic cases were observed more frequently in patients with complicated APN patients than uncomplicated patients (46.7% vs. 21.4%, p=0.001). No significant difference existed between the bacteremic and non-bacteremic patients in the prevalence of resistance to quinolone of E. coli. In multivariate logistic regression analysis, serum albumin (p= 0.023), hematuria (p=0.003), and age (p=0.003) at presentation were found to be independent risk factors for bacteremia in acute pyelonephritis. CONCLUSION: Our study reveals that patients with bacteremia have different clinical characteristics compared to those without bacteremia. It is recommended to concern about the presence of bacteremia in the treatment of APN.
Bacteremia ; Communicable Diseases ; Creatinine ; Female ; Hematuria ; Humans ; Logistic Models ; Medical Records ; Platelet Count ; Prevalence ; Pyelonephritis ; Retrospective Studies ; Risk Factors ; Serum Albumin ; Urinary Tract Infections

Biofilms are microbial communities that form on a surface and are surrounded by extracellular polymeric substances. Candida biofilms are a cause of infections associated with medical devices. In the present study, an attempt was made to evaluate a significance of biofilm formation ability (BF) in virulence of C. albicans. C. albicans of 98 isolates, 24 commensal strains obtained from the oral cavities of healthy volunteers, 29 from blood culture, 25 from urine culture, and 20 from vaginal candidiasis, were assayed for BF, an ability to adhere to epithelial cells (ADH), cell surface hydrophobicity (CSH), and germ tube forming rate (GT). The relationships of BF with CSH, ADH, and GT were statistically examined. A positive correlation between BF and ADH was obtained, but the correlation (r=0.326) was relatively low. To assess BF as a factor contributing for candidiasis, mice lethality test was performed. The 10 isolates with the highest BF (mean survival rate, 24%) allow to kill mice more than those with the 10 lowest BF (mean survival rate, 47%). In addition, clinical strains isolated from blood culture, urine culture, and vaginal candidiasis showed higher BF than oral commensal strains. These results suggest BF may represent a virulent characteristic of C. albicans.
Animals ; Biofilms ; Candida ; Candida albicans ; Candidiasis ; Epithelial Cells ; Hydrophobic and Hydrophilic Interactions ; Mice ; Polymers ; Survival Rate

Human immunodeficiency virus infection is not a common cause of Guillain-Barre syndrome. Guillain-Barre syndrome with cerebrospinal fluid pleocytosis has been associated with early human immunodeficiency virus (HIV) infection, occasionally as the presenting manifestation. We report a case of 73-year-old Korean malen with acute motor axonal variant of Guillain-Barre syndrome during chemotherapy for HIV- related Burkitt's lymphoma. This is the first report of Guillain-Barre syndrome occurringed within HIV infection in Korea.
Aged ; Axons ; Burkitt Lymphoma ; Guillain-Barre Syndrome ; HIV ; HIV Infections ; Humans ; Korea ; Leukocytosis

BACKGROUND: This study was aimed to identify the effect of oral care using 0.1% chlorhexidine gluconate (CHG) on ventilator-associated pneumonia (VAP) in the intensive care unit (lCU). METHODS: A total of 82 ventilated patient were enrolled in this prospective clinical trial performed during the 6-month period from October, 2005 through March, 2006. oral care was performed on the patients three times a day with 0.1% CHG for the study group and with 0.9% saline for the control group. To evaluate the colonization of potential pathogens, sputum cultures were taken on the first day of ventilation and followed on days 3, 5, 7, and 14. RESULTS: The overall incidence rate of YAP was 0.359 in the CHG-treated group compared to 0.116 in the NaCI-treated group (P=0.017). Likewise, 1000 device-day incidence rate of YAP was significantly lower in the CHG-treated group than in the NaCI-treated group (P=0.0396). However, among the patients whose initial sputrm cultures were positive , both the incidence rate (P=0.114) and 1000 device-day incidence rate (P=0.361) were not statistically significant. The average time from the day of ventilation to the onset of VAP among the patients whose initial sputrm cutures were positive was 14 days in the CHG-treated group and 9 days in the NaCI-treated group, but the difference was not statistically significant (P=0.169). CONCLUSION: An oral care with 0.1% CHG was helpful in controlling VAP in the ICU patients, but the effectiveness of CHG could not be confirmed in the patients whose initial sputrm cultures were positive.
Chlorhexidine* ; Colon ; Humans ; Incidence ; Intensive Care Units* ; Critical Care* ; Pneumonia, Ventilator-Associated* ; Prospective Studies ; Sputum ; Ventilation

BACKGROUND: Pregnant women are at an increased risk for severe illness and complications associated with pandemic (H1N1) 2009. This study was conducted to identify the severity of pandemic (H1N1) 2009 in pregnant Korean women. MATERIALS AND METHODS: The demographic and clinical data from pregnant women with laboratory confirmed pandemic (H1N1) 2009 during September to December 2009 were retrospectively collected from 8 hospitals in Korea. RESULTS: A total of 150 pregnant women with pandemic (H1N1) 2009 were identified. The median age was 30 years (range: 22-39 years), and the median gestational age (n=114) was 20 weeks (range: 1-39 weeks). All but one patient with secondary bacterial pneumonia had influenza without complication. Although 12 pregnant women needed hospitalization, there were no patients who needed admission to the intensive care unit or who died. Only one hospitalized patient had elective cesarean section because of oligohydamnios. No maternal or fetal complications directly related to the pandemic (H1N1) 2009 were identified among the 67 pregnant women who were followed up for 1 to 185 days after their influenza illness, including 6 women who delivered during the study period. CONCLUSIONS: In contrast with the reports from Western countries, pandemic (H1N1) 2009 among pregnant Korean women was mild.
Cesarean Section ; Female ; Gestational Age ; Hospitalization ; Humans ; Influenza, Human ; Intensive Care Units ; Pandemics ; Pneumonia, Bacterial ; Pregnancy ; Pregnant Women ; Retrospective Studies