PURPOSE: To compare the clinical characteristics and laboratory finding between adenoviral and group A streptococcal (GAS) pharyngitis. METHODS: A retrospective review of medical records was performed in the patients with adenovirus infection among those who were admitted for febrile respiratory disease from January 2011 to July 2013 and GAS pharyngitis among those who visited for symptoms of scarlet fever from August 2006 to July 2013. RESULTS: 179 patients (AV1 group) were diagnosed with adenoviral pharyngitis and 37 (AV2 group) of these patients had adenovirus single infection. 26 patients (GAS group) were diagnosed with scarlet fever. Adenoviral infection (AV2 group) developed in younger patients compared to GAS group (2.8+/-2.1 years vs. 5.4+/-1.8 years, P=0.000). Total durations of fever and admission were longer in AV2 (6.3+/-2.6 days vs. 3.3+/-1.9 days, P=0.000; 4.1+/-1.2 days vs. 1.9+/-1.8 days, P=0.000, respectively). WBC counts were higher in AV2 (11,449+/-5,680 cells/mm2 vs. 6,722+/-6,941 cells/mm2, P=0.000). CRP was not significantly different between AV2 and GAS group (3.8+/-3.2 mg/dL vs. 5.2+/-5.1 mg/dL, P=0.368). No difference was found between two groups in the percentage of antibiotics use (91.9% vs. 100%, P=0.261). CONCLUSION: Clinical characteristics and measures of inflammation in the laboratory findings were similar between adenoviral and GAS pharyngitis group. It is necessary to conduct the test for respiratory virus and bacteria in early stage to differentiate in the pharyngitis patients with leukocytosis and elevation of CRP level.
Adenoviridae ; Adenoviridae Infections ; Anti-Bacterial Agents ; Bacteria ; Child* ; Fever ; Humans ; Inflammation ; Leukocytosis ; Medical Records ; Pharyngitis* ; Retrospective Studies ; Scarlet Fever

Since the start of the antibiotic era, syphilis has become rare. However, in recent times, it has tended to be prevalent concomitantly with human immunodeficiency virus (HIV) infection and coinfection in North America and Europe. Now, such cases are expected to increase in elsewhere including Korea. A 40-year-old male patient visited hospital complaining of a headache for about one month. Brain computed tomography and magnetic resonance imaging, showed leptomeninged enhancing mass with edema an right porisylvian region, which was suspected to be glioma. Patient underwent a blood test and was diagnosed with syphilis and acquired immune deficiency syndrome. Partial cortical and subcortical resection were performed after small craniotomy. The dura was thick, adhered to the brain cortex, and was accompanied by hyperemic change of the cortex. The pathologic diagnosis was meningovascular syphilis (MS) in HIV infection. After the operation, the patient was treated with aqueous penicillin G. Thereafter, he had no neurological deficit except intermittent headache. At first, this case was suspected to be glioma, but it was eventually diagnosed as MS in HIV coinfection. At this point the case was judged to be worth reporting.
Acquired Immunodeficiency Syndrome ; Adult ; Brain ; Coinfection ; Craniotomy ; Edema ; Europe ; Glioma ; Headache ; Hematologic Tests ; HIV ; HIV Infections ; Humans ; Korea ; Magnetic Resonance Imaging ; Male ; Neurosyphilis ; North America ; Penicillin G ; Syphilis

BACKGROUND AND OBJECTIVES: Voice quality may be an important issue for choosing treatment options of early glottic cancer. It has been reported that voice quality is worse after laser cordectomy compared to that of radiation therapy. But, with developed visualization tools, the precise localization of lesions became possible enabling surgeons to decide the appropriate surgical extent to preserve voice after laser cordectomy. The authors assessed the postoperative voice quality of patients who underwent laser cordectomy according to the classification by the European Laryngological Society. SUBJECTS AND METHOD: Thirty patients who were diagnosed with glottic cancer and treated with laser cordectomy between April, 1999 and January, 2006, were evaluated. All the patients were followed-up more than 6 months. Objective evaluations included maximal phonation time, fundamental frequency, jitter, shimmer, noise-to-harmonics ratio and subjective evaluation was performed by the GRBAS scale. RESULTS: The type II laser cordectomy group and some cases of the type III cordectomy showed no significant differences compared with the normal control group in both objective and subjective evaluations. CONCLUSION: This study shows that the group of laser cordectomy type II and some cases of type III had acceptable results compared to that of the normal control group. Thus, laser cordectomy could be considered as an alternative to radiation therapy in selected patients with early glottic cancer, even when preserving the quality of voice is an important issue.
Humans ; Phonation ; Voice ; Voice Quality

Osteomyelitis of the pubic symphysis is not common and has often been reported to occur after urological or gynecological procedures. It can be spontaneous in origin but it also is associated with trauma, athletic exertion, pregnancy, and parturition. The early symptoms of osteomyelitis of the pubic symphysis mimic those of osteitis pubis, and therefore, the differential diagnosis between these two entities is of clinical importance. A fifty nine-year-old man who had previously received debridement and wide excision of perianal necrotizing fasciitis visited our hospital with pain on both inguinal areas. The core biopsy of the pubic symphysis and aspiration culture were performed, from which Pseudomonas aeruginosa was recovered. He was treated with parenteral ceftazidime for 5 days followed by cefepime for 7 weeks and showed favorable clinical response. To our knowledge, this is the first report on osteomyelitis of pubic symphysis resulting from debridement and wide excision of perianal necrotizing fasciitis in Korea.
Biopsy ; Ceftazidime ; Cephalosporins ; Debridement ; Diagnosis, Differential ; Fasciitis ; Fasciitis, Necrotizing ; Hydrazines ; Korea ; Osteitis ; Osteomyelitis ; Parturition ; Pregnancy ; Pseudomonas aeruginosa ; Pubic Symphysis ; Sports

Osteomyelitis of the pubic symphysis is not common and has often been reported to occur after urological or gynecological procedures. It can be spontaneous in origin but it also is associated with trauma, athletic exertion, pregnancy, and parturition. The early symptoms of osteomyelitis of the pubic symphysis mimic those of osteitis pubis, and therefore, the differential diagnosis between these two entities is of clinical importance. A fifty nine-year-old man who had previously received debridement and wide excision of perianal necrotizing fasciitis visited our hospital with pain on both inguinal areas. The core biopsy of the pubic symphysis and aspiration culture were performed, from which Pseudomonas aeruginosa was recovered. He was treated with parenteral ceftazidime for 5 days followed by cefepime for 7 weeks and showed favorable clinical response. To our knowledge, this is the first report on osteomyelitis of pubic symphysis resulting from debridement and wide excision of perianal necrotizing fasciitis in Korea.
Biopsy ; Ceftazidime ; Cephalosporins ; Debridement ; Diagnosis, Differential ; Fasciitis ; Fasciitis, Necrotizing ; Hydrazines ; Korea ; Osteitis ; Osteomyelitis ; Parturition ; Pregnancy ; Pseudomonas aeruginosa ; Pubic Symphysis ; Sports

D2GSNP is a web-based server for the selection of single nucleotide polymorph isms (SNPs) within genes related to human diseases. The D2GSNP is based on a relational database created by downloading and parsing OMIM, GAD, and dbSNP, and merging it with positional information of UCSC Golden Path. Totally our server provides 5,142 and 1,932 non-redundant disease genes from OMIM and GAD, respectively. With the D2GSNP web interface, users can select SNPs within genes responding to certain diseases and get their flanking sequences for further genotyping experiments such as association studies.
Databases, Genetic ; Humans* ; Polymorphism, Single Nucleotide*

Cytomegalovirus (CMV) is a prevalent pathogen, with 98~100% of Korean adults showing prior exposure by serology. A primary infection, such as CMV infectious mononucleosis, is very rare. CMV infectious mononucleosis often presents an initial diagnostic problem. Patients are often hospitalized with a wide variety of clinical diagnoses including fever of unknown origin without pharyngitis and lymphadenopathy. CMV gastrointestinal infections are rare in previously immunocompetent individuals. The most common sites involved are the colon and rectum, although lesions of the stomach have also been described. It is unusual to see CMV infectious mononucleosis and CMV gastrointestinal infection in the same patient. Our patient received symptomatic treatment and fully recovered. We present a case of CMV infectious mononucleosis with gastric ulcers in a previously healthy adult.
Adult ; Colon ; Cytomegalovirus ; Fever of Unknown Origin ; Humans ; Infectious Mononucleosis ; Lymphatic Diseases ; Pharyngitis ; Rectum ; Stomach ; Stomach Ulcer

We report a case of a 41-year-old man undergoing hemodialysis who presented with a sudden fever and dyspnea. He developed a severe pericardial effusion due to methicillin-resistant Staphylococcus aureus, which was identified in both blood and pericardial fluid cultures. He was successfully treated with intravenous vancomycin for 6 weeks. Although such cases are very rare in Korea, the current case describes a primary purulent pericarditis without any other potential infectious foci.
Adult ; Dyspnea ; Fever ; Humans ; Korea ; Methicillin-Resistant Staphylococcus aureus* ; Pericardial Effusion ; Pericarditis* ; Renal Dialysis* ; Vancomycin

Hepatic or splenic involvement of tuberculosis without other disseminated lesions is a very uncommon form of extrapulmonary tuberculosis, especially in an immunocompetent adult. We report a case of a 25 year-old-man who developed primary hepatosplenic tuberculosis not associated with the lung or other distant organs. He was initially diagnosed with esophageal candidiasis in local clinic. A computed tomographic scan of the abdomen showed hepatosplenomegaly and multiple microabscesses in the spleen. Our initial diagnosis, based on the clinical feature and radiologic findings, was hepatosplenic candidiasis. However, histopathology of the liver specimens revealed chronic granuloma with central caseous necrosis, strongly suggestive of tuberculosis. Although rare, splenic tuberculosis should be considered in the differential diagnosis of splenic abscess, especially in countries where tuberculosis is endemic.
Abdomen ; Abscess ; Adult ; Candidiasis ; Diagnosis, Differential ; Granuloma ; Humans ; Liver ; Lung ; Necrosis ; Spleen ; Tuberculosis ; Tuberculosis, Hepatic ; Tuberculosis, Splenic

OBJECTIVE: Device-associated infections in the central nervous system are serious complications of procedures involving indwelling devices among neurosurgical patients. In this study, the clinical characteristics and outcome of microbiologically confirmed device-associated cerebrospinal fluid (CSF) infection were evaluated. METHODS: We performed a retrospective analysis of adult patients found to have a positive CSF culture result during a hospital admission between 1 January 2005 through 2 October 2010 in Soonchunhyang University Hospital. RESULTS: During the study period, all episodes (n=161 CSF specimens, 87 patients) involving a culture-positive CSF were enrolled. Thirty-two episodes of device-associated CSF infection were included in the analysis among the study group. Most device-associated infections were ventriculo-peritoneal shunt infections (14/32, 44%). Fever (>38degrees C) was present in 17 episodes (53%). Overall, the most common microorganism was coagulase-negative staphylococcus (7/32 [22%]). Gram-negative rods (Pseudomonas aeruginosa 6/32 [19%], Acinetobacter baumannii/haemolyticus 5/32 [16%]) were identified in culture in 16/32 (50%). Device was removed for the control of device-associated infection in 30/32 (94%). Cure rate was 69% (22/32). All patients with treatment failure (10/32, 34%) expired. CONCLUSION: It is difficult to diagnosis device-associated CSF infections early since those are frequently presented with nonspecific clinical signs and symptoms. In our study, gram-negative infections accounted for 50% of cases and the empiric antibiotics initially chosen were found to not be effective against the final identified pathogen in many cases. Device-associated CSF infections should be strongly considered a serious risk factor associated with CSF infections, and prompt initiation of broad coverage antibiotics should be started after appropriate assessment.
Acinetobacter ; Adult* ; Anti-Bacterial Agents ; Central Nervous System ; Cerebral Ventriculitis ; Cerebrospinal Fluid* ; Diagnosis ; Fever ; Humans ; Meningitis ; Retrospective Studies ; Risk Factors ; Staphylococcus ; Treatment Failure ; Ventriculoperitoneal Shunt