Influenza causes variable epidemics annually and imposes public health problems and socioeconomic burden. They cause epidemic acute respiratory disease, characterized by fever, cough and systemic symptoms. The annual epidemics of seasonal influenza can affect any age group and result in serious illness or death, particularly in high risk populations such as adults > 65 years old, children < 2 years old and those with chronic medical condition at any age. Three types (A, B, and C) are recognized as well as many subtypes within the type A. New influenza A virus subtypes sporadically emerge in humans to cause widespread disease or pandemics. Antiviral therapy with oseltamivir or zanamivir is available and shorten the duration of illness and reduce the rate of complications. Influenza vaccines are effective in the prevention of influenza illness, although improved vaccines are needed.
Adult ; Child ; Cough ; Fever ; Humans ; Influenza A virus ; Influenza Vaccines ; Influenza, Human* ; Oseltamivir ; Pandemics ; Public Health ; Seasons ; Vaccines ; Zanamivir

Brucellosis is a zoonosis caused by several species of Brucella. Brucellosis is usually an acute or sub-acute febrile illness that histologically develops granulomatous inflammation. Brucella prostatitis is a very rare complication and is usually accompanied by epididymo-orchitis. We now report a case of histologically proven granulomatous prostatitis due to Brucella without clinical evidence of epididymo-orchitis. A 61-year-old farmer presented with myalgia, low back pain, and fever. A needle biopsy of the prostate was performed due to symptoms of urinary frequency and high prostate specific antigen levels (17.3 ng/mL). Histologically, the prostate showed granulomatous inflammation without caseous necrosis. Polymerase chain reaction (PCR) studies of blood and prostatic tissue for Brucella were positive, while a PCR study for Mycobacterium tuberculosis was negative. The patient was treated with doxycycline and rifampin. A possibility of Brucella prostatitis should be considered in the differential diagnosis of granulomatous prostatitis or prostatitis of unknown origin associated with or without epididymo-orchitis.
Biopsy, Needle ; Brucella ; Brucellosis ; Diagnosis, Differential ; Doxycycline ; Fever ; Granuloma ; Humans ; Inflammation ; Korea ; Low Back Pain ; Middle Aged ; Mycobacterium tuberculosis ; Necrosis ; Polymerase Chain Reaction ; Prostate ; Prostate-Specific Antigen ; Prostatitis ; Rifampin

Few studies have investigated cognitive impairment associated with globus pallidal lesion after acute mountain sickness (AMS). A 54-year-old mountaineer presented with a slowed response, social withdrawal, and apathy after exposure to high altitude. Neuropsychological evaluation revealed impairment in memory and frontal function. MRI revealed bilateral globus pallidal lesions and SPECT revealed decreased blood flow in the left temporal cortex. Symptoms and imaging findings were still impaired after 3 years. We speculate that globus pallidal lesions can cause cognitive dysfunction in AMS.
Altitude ; Altitude Sickness ; Apathy ; Globus Pallidus ; Humans ; Memory ; Middle Aged ; Tomography, Emission-Computed, Single-Photon

A severe adverse reaction to certain drug could be associated with hypersensitivity syndrome, showing the clinical features of infectious mononucleosis including maculopapular rash, fever, lymphadenopathy, leukocytosis, atypical lymphocytes, liver dysfunction, and renal disturbance. We report a systemic lupus erythematosus patient who developed infectious mononucleosis-like syndrome with administration of ceftriaxone/isepamicin for the treatment of pneumonia. This case warrants careful attention to infectious mononucleosis-like syndrome associated with antibiotics administration, especially in febrile patients with known autoimmune diseases such as systemic lupus erythematosus.

Chromobacterium violaceum (C. violaceum) is a gram negative, facultative anaerobe widely distributed in natural aquatic environments and is sensitive to temperature. Its infection has a predilection to tropical or subtropical regions that between latitude 35degrees N and 35degrees S. Infection due to C. violaceum is rare. But human infection with this organism can result in severe, systemic disease with a high fatality rate. C. violaceum infection may rapidly progress to sepsis with multiple organ abscesses, predominantly in lungs, liver, and spleen. The organism is usually resistant to most antibiotics commonly prescribed for gram-negative bacterial infection like aminoglycosides, extended spectrum beta-lactam antibiotics etc. In Korea, two cases of C. violaceum infections were reported in patients injured in a Guam airplane accident, and one case was reported local C. violaceum infection. Here, we report a case of fatal C. violaceum postoperative wound infection in Korea.
Abscess ; Aircraft ; Aminoglycosides ; Ankle Fractures* ; Ankle* ; Anti-Bacterial Agents ; Chromobacterium* ; Gram-Negative Bacterial Infections ; Guam ; Humans ; Korea ; Liver ; Lung ; Sepsis ; Spleen ; Surgical Wound Infection ; Wound Infection* ; Wounds and Injuries*

Since the first case of human immunodeficiency virus (HIV) infection was reported in Korea in 1985, the number of HIV patients has risen steadily and reached 5,323 in December 2007. Consequently, multiple opportunistic infections have become a significant clinical problem. Diseases of the gastrointestinal tract are among the most frequent complications of acquired immunodeficiency syndrome (AIDS) and cause morbidity in patients with HIV infection. Opportunistic infections are the leading cause of esophageal complaints. Candida albicans is the most frequently identified cause of esophageal symptoms, followed by herpes simplex virus (HSV) and cytomegalovirus (CMV) infections. Esophageal candidiasis often occurs concurrently with other infectious esophageal disorders. Simultaneous esophageal infection with HSV, CMV, and Candida spp. is rare. We report a case of combined HSV, CMV, and candidal esophagitis in an AIDS patient. He was treated with highly active antiretroviral therapy (HAART) and the appropriate antiviral and antifungal agents.
Acquired Immunodeficiency Syndrome ; Antifungal Agents ; Antiretroviral Therapy, Highly Active ; Candida ; Candida albicans ; Candidiasis ; Cytomegalovirus ; Esophagitis ; Gastrointestinal Tract ; Herpes Simplex ; HIV ; HIV Infections ; Humans ; Korea ; Methylmethacrylates ; Opportunistic Infections ; Polystyrenes ; Simplexvirus

An adrenal crisis is a serious medical emergency. Most such crises develop in patients with Addison's disease when they are stressed. However, the clinical features of an impending adrenal crisis are nonspecific, delaying diagnosis and management. Adrenal tuberculosis is very rare among the extrapulmonary forms of tuberculosis. We herein report a case of an adrenal crisis triggered by bilateral adrenal tuberculosis. A 35-year-old man was admitted to our hospital because of drowsiness, fever, and hypotension. Abdominal computed tomography revealed bilateral adrenal enlargement, and computed tomography-guided adrenal gland biopsy allowed us to diagnose adrenal tuberculosis.
Addison Disease ; Adrenal Glands ; Adrenal Insufficiency ; Adult ; Biopsy ; Diagnosis ; Emergencies ; Fever ; Humans ; Hypotension ; Sleep Stages ; Tuberculosis* ; Tuberculosis, Endocrine

Yellow fever is the original viral hemorrhagic fever (VHF), a pansystemic viral sepsis with viremia, fever, prostration, hepatic, renal, and myocardial injury, hemorrhage, shock, and high lethality. Yellow fever was one of the most feared lethal diseases before the development of an effective vaccine. Yellow fever (YF) can be prevented by an attenuated vaccine. The yellow-fever 17D vaccine developed in the 1930s has been regarded as one of the most successful live attenuated vaccines, with few side effects or adverse events. The adverse effects associated with yellow-fever vaccine are generally mild and include headache, myalgia, and low-grade fever. Recently, however, some cases of severe neurologic disease and multi-organ system disease have been described in individuals who received yellow-fever vaccine. We report the case of a 39-year-old female with meningitis following vaccination with 17D yellow-fever vaccine.
Adult ; Female ; Fever ; Headache ; Hemorrhage ; Hemorrhagic Fevers, Viral ; Humans ; Meningitis ; Sepsis ; Shock ; Vaccination ; Vaccines, Attenuated ; Viremia ; Yellow Fever

Dengue fever is an acute febrile disease caused by the dengue virus, which belongs to the family Flaviviridae. The increasing number of people traveling abroad has increased the number of cases of imported dengue fever in Korea. The most common symptoms in patients with dengue fever are malaise, fever, musculoskeletal pain, headache, nausea, vomiting, and abdominal pain. Neurological manifestations such as myelitis, encephalitis, and cranial nerve palsies have been recognized as clinical consequences of dengue infection, but meningitis is a rare complication. We report the case of a 38-year-old man who presented with fever, headache, and nuchal rigidity while traveling in Vietnam. The etiology of meningitis was confirmed by the presence of dengue IgM antibody in his serum. This case report highlights the potential of dengue infection as a cause of meningitis.
Abdominal Pain ; Adult ; Cranial Nerve Diseases ; Dengue ; Dengue Virus ; Encephalitis ; Fever ; Flaviviridae ; Headache ; Humans ; Immunoglobulin M ; Korea ; Meningitis ; Muscle Rigidity ; Musculoskeletal Pain ; Myelitis ; Nausea ; Neurologic Manifestations ; Vietnam ; Vomiting

Thrombocytopenia is a common manifestation of rickettsial disease. However, the pathogenesis of thrombocytopenia in many rickettsial diseases is poorly understood. Thrombocytopenia may be associated with consumption due to widespread endothelial damage or disseminated intravascular coagulation, hypersplenism, decreased marrow production, and immune-mediated platelet destruction. Some reports have found anti-platelet antibodies detected in thrombocytopenic patients with rickettsial disease. In addition to thrombocytopenia, facial palsy and Guillain-Barre syndrome were also reported as immune-mediated phenomena in scrub typhus. Here we report a case diagnosed as immune-mediated thrombocytopenia associated with scrub typhus. This is the first report of immune thrombocytopenic purpura (ITP) associated with scrub typhus in Korea. The patient exhibited eschar with a high titer of anti-tsutsugamushi antibody, thrombocytopenia, severe gastrointestinal hemorrhage, and purpura on the lower region of both legs. After steroid treatment, the sustained thrombocytopenia recovered.
Antibodies ; Blood Platelets ; Bone Marrow ; Disseminated Intravascular Coagulation ; Facial Paralysis ; Gastrointestinal Hemorrhage ; Guillain-Barre Syndrome ; Humans ; Hypersplenism ; Korea ; Leg ; Purpura ; Purpura, Thrombocytopenic, Idiopathic* ; Scrub Typhus* ; Thrombocytopenia