Acute diarrhea is one of the most common diseases that are seen in pediatric patients. In the management of acute diarrhea, several differential diagnostic criteria should be considered based on clinical and/or laboratory findings. These criteria include:(1) normal variant stool versus diarrhea (2) infectious versus non-infectious condition and (3) bacterial versus non-bacterial etiology. The use of antibiotics should be considered to manage diarrhea caused by bacteria accompanying fever and bloody diarrhea in the following cases:(1) patients with serious clinical course, (2) under three months, (3) immunocompromised patients, (4) patients with nutritional deficiency and (5) patients presenting with moderate-to-severe dehydration. In patients presenting with the symptoms suspected to be bacterial origin, whose clinical course is not serious, antibiotic therapy is not necessary. These patients are easily manageable at OPD level. Moreover, except for some cases in which the use of antibiotics is inevitable, pediatric diarrhea can be managed by providing the suitable foods alone with no necessity of other specific drugs. Accordingly, it is crucial not so much to depend on the drugs as to provide appropriate foods including oral rehydration solution(ORS) with no further episodes of diarrhea. Special attention should be paid to the fact that younger pediatric patients will undergo nutritional deficiency unless acute diarrhea is properly managed.
Anti-Bacterial Agents ; Bacteria ; Dehydration ; Diarrhea* ; Fever ; Fluid Therapy ; Humans ; Immunocompromised Host ; Malnutrition

Harlequin ichthyosis is a most severe form of lamellar ichthyosis, which is one of congenital ichthyosis, and X- linked inherited, very rare, fatal congenital dermatologic disorder. At second trimaster in utero, skin deformity is occurred. We experienced a case of Harlequin baby in female neonate who showed typical skin appearance at birth. The nose and were flattened. The chemosis and severe ectropion obscured the orbit, and her lips were everted. The all joints were flexed due to inelastic skin, and hands and feets were fixed and ischemic. Diagnosis was established by clinical features and histopathological studies. A brief review of literature was made.
Congenital Abnormalities ; Diagnosis ; Ectropion ; Female ; Foot ; Hand ; Humans ; Ichthyosis ; Ichthyosis, Lamellar* ; Infant, Newborn ; Joints ; Lip ; Nose ; Orbit ; Parturition ; Skin

This study aims to identify the clinical characteristics for diagnosing streptococcal pharyngitis. The correlation between eighteen clinical manifestations and rapid antigen detection test results was analyzed. Among 205 patients, five clinical manifestations, pharyngeal hemorrhage (odds ratio [OR] = 11.85), palatal hemorrhage (OR = 9.32), tonsillar swelling (OR = 4.37), rash (OR = 3.02), and enlarged cervical nodes (OR = 1.91), were significantly correlated with group A Streptococcus (GAS) pharyngitis. Traditional indicators such as fever, pharyngeal redness, acute onset, headache, rhinorrhea, cough, tonsillar exudate, and cervical tenderness were not statistically related to GAS pharyngitis. Therefore, physicians should be cautious in using these traditional indicators

This study aims to identify the clinical characteristics for diagnosing streptococcal pharyngitis. The correlation between eighteen clinical manifestations and rapid antigen detection test results was analyzed. Among 205 patients, five clinical manifestations, pharyngeal hemorrhage (odds ratio [OR] = 11.85), palatal hemorrhage (OR = 9.32), tonsillar swelling (OR = 4.37), rash (OR = 3.02), and enlarged cervical nodes (OR = 1.91), were significantly correlated with group A Streptococcus (GAS) pharyngitis. Traditional indicators such as fever, pharyngeal redness, acute onset, headache, rhinorrhea, cough, tonsillar exudate, and cervical tenderness were not statistically related to GAS pharyngitis. Therefore, physicians should be cautious in using these traditional indicators

Virus-associated immune thrombocytopenic purpura (ITP) can occur following common viruses, but cases of ITP associated with influenza infection has seldom been reported. In this report we describe a previously healthy 5-year-old boy who admitted with fever, flu-like symptoms and a few bruises on both legs. Severe thrombocytopenia were found. Bone marrow aspirates and biopsy showed no abnormalities and results of coagulation tests were all in normal limit. Real-time polymerase chain reaction was positive for influenza B infection. The patient fully recovered with intravenous immunoglobulins and steroid therapy.
Biopsy ; Bone Marrow ; Child, Preschool ; Contusions ; Fever ; Humans ; Immunoglobulins, Intravenous ; Influenza B virus* ; Influenza, Human* ; Leg ; Male ; Purpura, Thrombocytopenic, Idiopathic* ; Real-Time Polymerase Chain Reaction ; Thrombocytopenia

Posterior reversible leukoencephalopathy syndrome is a clinical radiographic syndrome of many causative factors. Sudden onset headache, vomiting, altered mental status, blurred vision and seizures are main symptoms shown in posterior reversible leukoencephalopathy syndrome. In addition, it typically shows radiological findings of edema in the white matter of posterior cerebrum, being in commonly bilateral but asymmetric. We report a case of poststreptococcal glomerulonephritis (PSGN) presenting as posterior reversible leukoencephalopathy syndrome. Immediate control of hypertension resulted in rapid and complete neurological recovery.
Cerebrum ; Edema ; Glomerulonephritis* ; Headache ; Hypertension ; Leukoencephalopathies* ; Posterior Leukoencephalopathy Syndrome ; Seizures ; Streptococcal Infections ; Vomiting

BACKGROUND: The SD Bioline Strep A Ultra (SD, Yongin, Korea) is a recently developed rapid antigen detection test (RADT) for diagnosing bacterial pharyngitis caused by Group A Streptococcus, We evaluated the performance of SD Bioline Strep A Ultra, using the number of colony forming units and color intensity. METHODS: Three throat swabs each were taken from 343 children with pharyngitis who visited pediatric clinics. We evaluated the performance of SD Bioline Strep A Ultra and compared its positive rate with the number of colony forming units, using the Fisher exact test. RESULTS: The sensitivity, specificity, positive predictive value, and negative predictive value (95% confidence interval) were 97.4% (94.0–99.1%), 90.8% (85.0–94.9%), 93.0% (88.5–96.1%), and 96.5% (92.0–98.9%), respectively. Positive rate significantly differed by number of colony forming units (P=0.021). ROC plot for color intensity showed 0.938 of AUC (area under curve). CONCLUSIONS: SD Bioline Strep A Ultra showed excellent performance, and its positive rate differed by the number of colony counts. This RADT could be used as a sensitive and semi-quantitative method detecting bacterial pharyngitis.
Area Under Curve ; Child ; Gyeonggi-do ; Humans ; Methods ; Pharyngitis ; Pharynx ; Sensitivity and Specificity ; Stem Cells* ; Streptococcus

Background: Pharyngitis is one of the most common conditions encountered in primary health care facilities. Accurate differentiation of group A streptococcus (GAS) infection from viral infection is difficult. The STANDARD F Strep A Ag FIA (SD BIOSENSOR, Korea) is a rapid antigen detection test (RADT) that has been recently developed for diagnosing GAS pharyngitis. In this study, we evaluated the diagnostic performance of the STANDARD F Strep A Ag FIA and compared the results between the RADT and conventional throat culture. Methods: Throat swab samples were obtained from a total of 372 children presenting pharyngitis symptoms in five pediatric clinics in Changwon, Korea from July 2018 to October 2019. A comparative study between STANDARD F Strep A Ag FIA and Sofia Strep A FIA (Quidel, USA) was performed. Two throat swabs were taken simultaneously from each patient for RADT. The third throat swab was stored in a transport tube containing Stuart's transport medium for culture. Performance and kappa index of STANDARD F Strep A Ag FIA were evaluated. Results: GAS infection was detected in 29.3% (109/372) patients, using the STANDARD F Strep A Ag FIA. The sensitivity, specificity, positive predictive value, and negative predictive value were 95.0%, 95.2%, 88.1%, and 98.1%, respectively. The STANDARD F Strep A Ag FIA showed an excellent concordance rate of 96.5% and a kappa value of 0.89 compared to Sofia Strep A FIA. Conclusion The STANDARD F Strep A Ag FIA demonstrated an excellent performance along with Sofia Strep A FIA for the diagnosis of GAS pharyngitis.