Staphylococcus epidermidis is a normal inhabitant of skin, throat, mouth, vagina, and urethra. It is not usually pathogenic, particularly in immunocompetent hosts. This report describes a case of a pyogenic liver abscess caused by Staphylococcus epidermidis in a healthy 12-year-old boy. He was admitted to Seoul St. Mary's Hospital with intermittent fever for 6 days. Findings on abdominal computed tomography (CT) showed a mass measuring 7.0x6.5 cm in the right hepatic lobe. Culture of the abscess resulted in growth of Staphylococcus epidermidis as a causative organism. The patient was successfully treated with intravenous administration of antibiotics and percutaneous drainage of the abscess.
Abscess ; Administration, Intravenous ; Anti-Bacterial Agents ; Child ; Drainage ; Fever ; Humans ; Liver Abscess ; Liver Abscess, Pyogenic ; Mouth ; Pharynx ; Skin ; Staphylococcus ; Staphylococcus epidermidis ; Urethra ; Vagina

PURPOSE: The purpose of this study was to describe the epidemiologic features of febrile illnesses in newborns and to predict the risk of serious infections in this population. METHODS: A retrospective study was conducted on 123 full-term infants <30 days of age with an axillary temperature >38 degrees C who were hospitalized between 2000 and 2006. Neonates with prenatal risk factors, congenital anomalies, antibiotic administration prior to admission to the hospital, or suspected hospital-acquired infections were excluded. We evaluated the symptoms, physical examination findings, laboratory data, and clinical course between the high- and low-risk groups for serious infections. RESULTS: The high-risk group included 30 infants with the following diagnoses in order of frequency: aseptic meningitis, urinary tract infection, bacterial meningitis, infectious enteritis, sepsis concomitant with disseminated intravascular coagulopathy, bacteremia, pneumonia, cellulitis, and omphalitis. Leukocytosis and thrombocytopenia were statistically different between the two groups. Factors, such as moaning signs, seizures, body temperature, and pulse rate were statistically significant. CONCLUSION: Unlike previous studies, we included newborns with clinical bacterial infections and aseptic meningitis as the high-risk group. Leukocytosis, thrombocytopenia, moaning signs, seizures, and changes in vital signs were considered useful predictors for identifying febrile neonates at high-risk for serious infections in spite of a difference in the definition of serious infection.
Bacteremia ; Bacterial Infections ; Body Temperature ; Cellulitis ; Enteritis ; Fever ; Heart Rate ; Humans ; Infant ; Infant, Newborn ; Leukocytosis ; Meningitis, Aseptic ; Meningitis, Bacterial ; Physical Examination ; Pneumonia ; Retrospective Studies ; Risk Factors ; Seizures ; Sepsis ; Thrombocytopenia ; Urinary Tract Infections ; Vital Signs

Thanatophoric dysplasia (TD) is a lethal inherited skeletal disorder characterized by extremely short limbs, narrow chest, skull deformity and underdeveloped lungs. TD is divided into two types, depending primarily upon whether the bone in the upper leg (the femur) is curved or straight. We experienced two case of TD type I that were confirmed by clinical and radiological features after birth. Unlike previously reported cases of TD in our country, the multiple anomalies of CNS, kidney and cardiovascular system were identified in one of these cases.
Cardiovascular System ; Congenital Abnormalities ; Extremities ; Kidney ; Leg ; Lung ; Parturition ; Skull ; Thanatophoric Dysplasia ; Thorax ; Ultrasonography, Prenatal

Background: Acute bronchiolitis, the most common lower respiratory tract infection in infants, is mostly caused by respiratory viruses. However, antibiotics are prescribed to about 25% of children with acute bronchiolitis. This inappropriate use of antibiotics for viral infections induces antibiotic resistance. This study aimed to determine the antibiotic prescription rate and the factors associated with antibiotic use in children with acute bronchiolitis in Korea, where antibiotic use and resistance rates are high. Methods: Healthcare data of children aged < 24 months who were diagnosed with acute bronchiolitis between 2016 and 2019 were acquired from the National Health Insurance system reimbursement claims data. Antibiotic prescription rates and associated factors were evaluated. Results: A total of 3,638,424 visits were analyzed. The antibiotic prescription rate was 51.8%, which decreased over time (P < 0.001). In the multivariate analysis, toddlers (vs. infants), non-capital areas (vs. capital areas), primary clinics and non-tertiary hospitals (vs. tertiary hospitals), inpatients (vs. outpatients), and non-pediatricians (vs. pediatricians) showed a significant association with antibiotic prescription (P < 0.001). Fourteen cities and provinces in the non-capital area exhibited a wide range of antibiotic prescription rates ranging from 41.2% to 65.4%, and five (35.7%) of them showed lower antibiotic prescription rates than that of the capital area. Conclusion In Korea, the high antibiotic prescription rates for acute bronchiolitis varied by patient age, region, medical facility type, clinical setting, and physician specialty. These factors should be considered when establishing strategies to promote appropriate antibiotic use.

We report a 13-year-old girl with multiple angiokeratomas on lower extremity. Her skin lesions were asymptomatic but became larger and darker and bled intermittently with subtle trauma. Skin biopsy confirmed the diagnosis of angiokeratoma. We emphasize the importance of this lesion in the differential diagnosis of pigmented nevus or malignant melanoma.
Adolescent ; Angiokeratoma* ; Biopsy ; Diagnosis ; Diagnosis, Differential ; Female ; Humans ; Lower Extremity ; Melanoma ; Nevus, Pigmented ; Skin

We report a 37-year-old man who had a cutaneous marker of tuberous sclerosis with angiofibromas, periungal fibromas and who also showed bilateral verrucous hemangiomas on buttock. It is not known whether there is association between verrucous hemangioma and tuberous sclerosis, but there are some evidence suggest a more than chance association. We describe a case of bilateral verrucous hemangiomas combined with tuberous sclerosis.
Adult ; Angiofibroma ; Buttocks ; Fibroma ; Hemangioma* ; Humans ; Tuberous Sclerosis*

PURPOSE: We conducted the immunoassay of pertussis according to ages, in order to evaluate protective immunity against pertussis in Korean populations. METHODS: Healthy subjects were enrolled at four university hospitals in Korea. The subjects were grouped as seven age groups (every 10 years). Antibodies against pertussis toxin (PT) in sera were measured by enzyme linked immunosorbent assay (ELISA) kits. Geometric mean concentrations (GMC) of antibodies and the ratios of the subjects with seroprotective antibody levels were determined. The subjects with antibody titers > or =24.0 EU/mL were considered to seroprotective as the manufacturer's protocol. RESULTS: Total 1,605 subjects (age: 2 months-65 years) participated in this study, and their GMC was 56.16+/-50.54 EU/mL. Among seven age groups, age group <11 year showed the highest GMC (64.78+/-53.24 EU/mL) (P<0.001). In the analysis of the ratios of the subjects with seroprotective antibody titers, 68.2% of the subjects were proven to seroprotective, and age group <11 year also showed the highest ratio (76.5%) (P<0.001). CONCLUSIONS: We found that adolescences or adults (age group > or =11 year) showed lower levels of antibody against pertussis and lower ratio of the subjects with seroprotective antibody titers than children (age group <11 year).
Adult ; Antibodies ; Child ; Enzyme-Linked Immunosorbent Assay ; Hospitals, University ; Humans ; Immunization ; Immunoassay ; Korea ; Pertussis Toxin ; Whooping Cough

The coronavirus disease 2019 (COVID-19) pandemic is unlikely to end soon, and hospitals face a high risk of exposure to COVID-19 and nosocomial infections. Therefore, strengthened infection control and prevention (ICP) strategies are crucial. Here, we share our experience of activities implemented by an infection control surveillance-working group (ICS-WG) and the introduction of a hospital emergency code for patients requiring screening for COVID-19, which were established at a university-affiliated hospital. This hospital applies multi-step processes to identify patients who must visit the outdoor screening clinic for COVID-19 testing, instead of entering the hospital building. However, some of these patients inevitably end up inside the hospital building. To solve this issue, we implemented a process to announce the emergency code (“code apple”) and have the medical personnel escort such patients to the outdoor screening clinic. This process was useful in protecting the hospital from unnecessary exposure to COVID-19. The ICS-WG was assigned to conduct the surveillance of ICP practices, patrol the hospital, and recommend improvements for any practices that did not adhere to the guidelines. The ICS-WG also developed a checklist as a monitoring tool for ICP practices. The checklists were distributed to the infection control coordinators who were assigned to monitor their team’s ICP practices and report to the ICS-WG. Overall, we believe that code apple and the ICS-WG are effective strategies in improving ICP practices of COVID-19 at hospitals.

A recent resurgence of pertussis has raised public health concerns even in developed countries with high vaccination coverage. The aim of this study was to describe the clinical characteristics of infant pertussis, and to determine the relative importance of household transmission in Korea. The multicenter study was prospectively conducted from January 2009 to September 2011. We identified the demographic and clinical data from these patients and performed the diagnostic tests for pertussis in their household contacts. Twenty-one patients with confirmed pertussis were included in the analysis. All infections occurred in infants younger than 6 months of age (mean age, 2.5 months) who had not completed the primary DTaP vaccination except for one patient. Infants without immunization history had a significant higher lymphocytosis and longer duration of hospital stay compared to those with immunization. All were diagnosed with PCR (100%), however, culture tests showed the lowest sensitivity (42.9%). Presumed source of infection in household contacts was documented in 85.7%, mainly parents (52.6%). Pertussis had a major morbidity in young infants who were not fully immunized. Household members were responsible for pertussis transmission of infants in whom a source could be identified. The control of pertussis through booster vaccination with Tdap in family who is taking care of young infants is necessary in Korea.
Bordetella pertussis/genetics ; Diphtheria-Tetanus-acellular Pertussis Vaccines/immunology ; Female ; Humans ; Immunization, Secondary ; Infant ; Length of Stay ; Lymphocytosis/etiology ; Male ; Parents ; Polymerase Chain Reaction ; Prospective Studies ; Republic of Korea ; Whooping Cough/diagnosis/immunology/*transmission

PURPOSE: Clinical and laboratory features of two Kawasaki disease (KD) groups were evaluated; the patient with pyuria and those without pyuria. METHODS: From January 2015 to December 2016, the medical records of 140 (86 males and 54 females) inpatients with KD were retrospectively analyzed. RESULTS: Forty-eight KD patients (34.3%) presented with pyuria. KD patients with pyuria showed a higher level of C-reactive protein (CRP) and a higher proportion of elevated liver enzymes than those without pyuria. There were no differences in the proportions of unresponsiveness to intravenous immunoglobulin and coronary artery lesions between the two groups. Six KD patients (12.5%) with pyuria underwent a renal imaging study to rule out the possibility of a urinary tract infections. Thirty-two KD patients (66.7%) with pyuria received treatment with antibiotics in addition to the standard treatment for KD. CONCLUSIONS: KD patients with pyuria showed a higher level of CRP and elevated levels of liver enzymes than those without pyuria. These findings suggest that KD patients with pyuria have more severe systemic inflammation than those without pyuria.
Anti-Bacterial Agents ; C-Reactive Protein ; Child ; Coronary Vessels ; Fever ; Humans ; Immunoglobulins ; Inflammation ; Inpatients ; Liver ; Male ; Medical Records ; Mucocutaneous Lymph Node Syndrome* ; Pyuria* ; Retrospective Studies ; Urinary Tract Infections