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Prevalence of Viruses with Diarrhea among Hospitalized Children West Gyeonggi Province.

Soo Young SEO ; In Ah JUNG ; Ji Hoon KIM ; Kyung Soon CHO ; Joong Hyun BIN ; Hyun Hee KIM ; Hee Jin LEE ; Wonbae LEE

Korean Journal of Pediatric Infectious Diseases.2012;19(1):28-36.

PURPOSE: This study was conducted to evaluate epidemiological data of the viral pathogens obtained from stool exams and provide information on the regional prevalence of infectious diarrheal disease west in Gyeonggi Province, Korea. METHODS: We enrolled a cohort of children <10 years of age admitted for treatment of acute diarrhea at Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea. In total, 310 fecal specimens, documented to be free of common bacterial pathogens, were collected from pediatric patients during a 12-month period from January to December 2009 and were tested for the presence of rotavirus, parechovirus, adenovirus, astrovirus, enterovirus, and norovirus using polymerase chain reaction (PCR) and reverse transcription polymerase chain reaction (RT-PCR) assay. RESULTS: The most common virus was parechovirus (16%), followed by adenovirus (15%), astrovirus (14%), rotavirus (13%), and enterovirus (5%). Interestingly, only one of the specimens was positive for norovirus. Single infection cases were detected in 173 (55.8%) of the 310 children, whereas mixed viral infections were detected in 10 (3.2%) of the same children. Viral gastroenteritis generally showed a double peak of incidence. Parechovirus, rotavirus, and adenovirus shared a similar pattern of peak incidence with overall viruses; however, astrovirus infections occurred more frequently in the spring. Eighty-five percent of the confirmed viral gastroenteritis cases developed in under 24 months. CONCLUSION: The results support the importance of parechovirus, adenovirus, astrovirus, and enterovirus as causative agents of diarrhea in children, which may be underestimated by current routine diagnostic testing.
Adenoviridae ; Child ; Child, Hospitalized ; Cohort Studies ; Diagnostic Tests, Routine ; Diarrhea ; Dysentery ; Enterovirus ; Gastroenteritis ; Humans ; Incidence ; Korea ; Norovirus ; Parechovirus ; Polymerase Chain Reaction ; Prevalence ; Reverse Transcription ; Rotavirus ; Viruses

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A Nationwide Survey on the Child Day Care and Common Infectious Diseases.

Jong Gyun AHN ; Seong Yeol CHOI ; Dong Soo KIM ; Ki Hwan KIM

Korean Journal of Pediatric Infectious Diseases.2012;19(1):19-27.

PURPOSE: As the number of children who attend child care centers has increased, concerns has increased about the effect of child day care on childhood illness. This study was conducted to examine the relationship between experience in child care and common infectious diseases in children under 5 years of age. METHODS: Data were collected by surveying 1,000 respondents with children under age 5 through online interviews using a structured questionnaire. The contents of the survey were composed of demographic characteristics, child care facilities usage, experience in infectious diseases, and immunization status. RESULTS: Among the 1,000 children <5 years of age, 78.5% attended a child care facility. Rates of common communicable illnesses were higher in children in child care than for children reared exclusively at home. The predominant communicable diseases which the respondents' children experienced, in order of decreasing frequency, were gastroenteritis (47.1%), otitis media (41.8%) and pneumonia (19.1%). The immunization rate of vaccines that are not included the national immunization program (NIP) (Haemophilus influenzae type b vaccine - 76.6%, hepatitis A vaccine - 63.3%, pneumococcal vaccine - 59.4%, rotavirus vaccine - 43.1%) was lower than that of the NIP vaccines (90.4%). CONCLUSION: Children in child care experience more bouts of common infectious disease, so nationwide policies to prevent or to control the spread of infectious agents in a child-care should be available and appropriate immunization should be emphasized as the most effective method for the control of infectious disease for children.
Child ; Child Care ; Communicable Diseases ; Surveys and Questionnaires ; Day Care, Medical ; Gastroenteritis ; Hepatitis A Vaccines ; Humans ; Immunization ; Immunization Programs ; Influenza, Human ; Otitis Media ; Pneumonia ; Rotavirus ; Vaccination ; Vaccines

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A Case of Tuberculous Enteritis with Active Pulmonary Tuberculosis in a 12-Year-Old Girl.

Ga Young PARK ; Jae Young PARK ; Chang Hwi KIM ; Jeong Ja KWAK ; Jae Ock PARK

Korean Journal of Pediatric Infectious Diseases.2013;20(3):190-196.

Intestinal tuberculosis (TB) is presented with nonspecific and variable clinical manifestations such as abdominal pain, diarrhea, fever and weight loss. Diagnosis of tuberculous enteritis may be missed or confused with many other chronic gastrointestinal disorders such as the Crohn disease and intestinal neoplasms. The diagnosis should be based on careful clinical evaluations, such as extra-intestinal signs and colonoscopic and histologic findings. Newer techniques such as PCR tests from the specimens through colonoscopic biopsy may be helpful to confirm diagnosis of tuberculous enteritis. The treatment regimens for pulmonary tuberculosis are generally effective for tuberculous enteritis as well. If not treated early, the prognosis of intestinal tuberculosis is poor. We report a case of tuberculous enteritis diagnosed by colonoscopic biopsy and TB PCR which was presented with diarrhea, abdominal pain, intermittent fever and weight loss in a 12-year-old girl with active pulmonary tuberculosis. The patient was treated successfully with antituberculosis agents for 11 months without any complications.
Abdominal Pain ; Biopsy ; Child* ; Crohn Disease ; Diagnosis ; Diarrhea ; Enteritis* ; Female* ; Fever ; Humans ; Intestinal Neoplasms ; Polymerase Chain Reaction ; Prognosis ; Tuberculosis ; Tuberculosis, Pulmonary* ; Weight Loss

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The First Pediatric Case of Intrathoracic Tuberculosis Lymphadenitis Diagnosed by Endobronchial Ultrasound Guided Transbronchial Needle Aspiration.

Kwang Hoon KIM ; Kyung Jong LEE ; Yae Jean KIM

Korean Journal of Pediatric Infectious Diseases.2013;20(3):186-189.

Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) now provides an important alternative diagnostic modality in patients with intrathoracic tuberculosis lymphadenopathy. The procedure is well tolerated in the outpatient setting, provides access to the mediastinal and hilar lymph node locations commonly in tuberculosis and also allows bronchial washing to be performed at the same procedure. However, there is no report of EBUS-TBNA applied to children to diagnose tuberculosis. We report a case of EBUS-TBNA applied to children who had intrathoracic tuberculosis lymphadenopathy.
Child ; Humans ; Lymph Nodes ; Lymphadenitis* ; Lymphatic Diseases ; Needles* ; Outpatients ; Tuberculosis* ; Ultrasonography*

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Two Children with Nontyphoidal Salmonellosis Assumed by Pets.

Jong Deok KIM ; Seong Yeol CHOI ; Dong Soo KIM ; Ki Hwan KIM

Korean Journal of Pediatric Infectious Diseases.2013;20(1):41-45.

Nontyphoidal Salmonella are gram negative bacilli organism, which may induce systemic infection such as febrile enteritis, bacteremia, and osteomyelitis. Main route of infection is known as food but also possible through reptile, amphibian, and fish raised as pets in the house. There is no known cases report of Salmonella infection through pets in Korea and also rare in the overseas. We report 2 patients who visited Severance children's hospital with chief complaint of fever and diagnosed as nontyphoidal salmonellosis. Each case had a history of raising turtle or tropical fish with possibility of Salmonella infection through these pets. Increasing incidence of raising pet reptile and fish lately, contact precaution and proper prevention and control of Salmonella infection of these pets especially in children under 5 years old are necessary due to higher risk of serious complications of salmonellosis.
Amphibians ; Bacteremia ; Child ; Enteritis ; Fever ; Fishes ; Humans ; Incidence ; Korea ; Osteomyelitis ; Reptiles ; Salmonella ; Salmonella Infections ; Turtles

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A Case of Pyogenic Liver Abscess Caused by Staphylococcus epidermidis in a Healthy Child.

Ji Hye GWAK ; Yeun Joo EEM ; Ui Yoon CHOI ; Jin Han KANG

Korean Journal of Pediatric Infectious Diseases.2013;20(1):36-40.

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

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Clinical Manifestation of Human Metapneumovirus Infection in Korean Children.

Jung Min AHN ; Seong Yeol CHOI ; Dong Soo KIM ; Ki Hwan KIM

Korean Journal of Pediatric Infectious Diseases.2013;20(1):28-35.

PURPOSE: The aim of this study was to determine the frequency, epidemiology and the clinical manifestation of human metapneumovirus (hMPV) infection in Korean children. METHODS: From February 2010 to January 2012, we collected nasopharyngeal aspiration from 1,554 children who were hospitalized for acute lower respiratory tract infections at the Department of Pediatrics, Severance Children's Hospital. hMPV was detected by performing reverse transcriptase-polymerase chain reaction (RT-PCR). The medical records of the patients with positive results were retrospectively reviewed. RESULTS: We detected hMPV in 99 of the 1,554 hospitalized children. The mean age of the hMPV infected children was 25 months, and 87% of the illnesses occurred between April and June. The most common diagnoses were pneumonia (73%) and bronchiolitis (16%). The clinical manifestations included cough, fever, respiratory distress, hoarseness, tachypnea, and wheezing. Coinfection with other respiratory viruses was found in 43 children (43%). CONCLUSION: hMPV is one of the major virus causing acute respiratory tract infection in the age between 13 months and 48 months old with peaks during April to June. Reports of hMPV in Korea has been increasing but additional studies are required to define the epidemiology and the extent of disease caused by hMPV to determine future development of this illness in Korean children.
Bronchiolitis ; Child ; Child, Hospitalized ; Coinfection ; Cough ; Fever ; Hoarseness ; Humans ; Korea ; Medical Records ; Metapneumovirus ; Pediatrics ; Pneumonia ; Respiratory Sounds ; Respiratory Tract Infections ; Retrospective Studies ; Tachypnea ; Viruses

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Comparison of Results between Tuberculin Skin Test and QuantiFERON(R)-TB In-Tube Assay for Diagnosis of Latent Tuberculosis Infection in Children and Adolescents.

Jong Won CHOI ; Min Sung KIM ; Jong Hyun KIM

Korean Journal of Pediatric Infectious Diseases.2013;20(1):17-27.

PURPOSE: Recently, two tests are commercially available for the identification of latent tuberculosis infection (LTBI): tuberculin skin test (TST) and interferon-gamma release assay (IGRA). Due to its false positiveness, TST tends to be preferred by IGRA until now. In our study, we simultaneously performed both TST and QuantiFERON(R)-TB Gold In-Tube (QFT-GIT) and compared their results. METHODS: TST and QFT-GIT were done for the diagnosis of LTBI among children who visited pediatric out-patient clinic at St. Vincent's Hospital, The Catholic University of Korea from February of 2007 to May of 2008. The study group was stratified into two groups in terms of whether there was intrafamilial contact or not. RESULTS: Out of total 35 children, 29 were tuberculosis (TB)-exposed cases and the remainders were diagnosed as clinical pulmonary TB. Among these 29 children, TST was positive 38.9% (7/18) for the intrafamilial and 45.5% (5/11) for the non-intrafamilial, and at the same time, the result for QFT-GIT was positive 5.6% (1/18) and 9.1% (1/11), respectively which implies that TST was more sensitive than QFT-GIT. Among 29 TB-exposed cases, 26 initially went through TST and QFT-GIT together on their first visit to out-patient clinic, and 15 continued the follow-up tests. Out of total 41 cases collected, the agreement (known as kappa value) was 0.063 which was relatively low. Including 6 cases with pulmonary TB who were all positive for TST and only 5 being positive for QFT-GIT, the final kappa value was 0.334. CONCLUSION: In our study, the agreement for TST and QFT-GIT was low, and the majorities were almost the cases of positive TST. In current situation with lacking a gold standard test and limited data on children to adolescents, this result is quite alarming that the recent trend tends to replace TST by QFT-GIT when diagnosing LTBI.
Adolescent ; Child ; Follow-Up Studies ; Humans ; Interferon-gamma Release Tests ; Korea ; Latent Tuberculosis ; Outpatients ; Skin ; Skin Tests ; Tuberculin ; Tuberculosis

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Five Year Experience of Preexposure and Postexposure Rabies Prophylaxis in Korean Children at the National Medical Center.

Jin Chul NOH ; Hyang Mi PARK ; Jong Hyun PARK ; Youn Kyung WON ; Chang Hyu LEE ; Jae Yoon KIM

Korean Journal of Pediatric Infectious Diseases.2013;20(1):9-16.

PURPOSE: This study aims to investigate preexposure prophylaxis and postexposure prophylaxis of rabies that the National Medical Center (NMC) handled and to check whether appropriate measures were performed according to the recent domestic and overseas guidelines after animal bites. METHODS: This study surveyed 41 people who were 18 years or under and received preexposure and postexposure prophylaxis of rabies at the NMC from November 2006 to December 2011. Their medical records were reviewed for their age, gender, the reason for preexposure prophylaxis, the body sites of animal bite, the kind of the animal that bit children, the region where the biting occurred and rabies vaccination and inoculation of immunoglobulin. RESULTS: Eleven children took rabies vaccination for preexposure prophylaxis and 30 children received post exposure prophylaxis of rabies. Of patients who were bitten by unvaccinated animals including wild animals or by animals which were not certain to be vaccinated, 50% (13 of 26 children) received postexposure prophylaxis, while 75% (3 of 4 children) of patients who were bitten by vaccinated animals received postexposure prophylaxis of rabies. Ten of 30 bitten patients knew whether or not the biting animals had received rabies vaccination. Of them, four people (40%) were bitten by animals which had received rabies vaccination. CONCLUSION: To prevent the occurrence of rabies, people and health care providers need to correctly understand latest guideline for rabies preexposure and postexposure prophylaxis and the information for bitten patient, biting animal and area at bitten by animal should be accurately recorded.
Animals ; Animals, Wild ; Bites and Stings ; Child ; Child Health ; Health Personnel ; Humans ; Isothiocyanates ; Medical Records ; Post-Exposure Prophylaxis ; Rabies ; Vaccination

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Clinical Manifestations of Salmonellosis in Children during the last 12 Years: A Single Institution Experience.

Jae Hong PARK ; Taek Jin LEE

Korean Journal of Pediatric Infectious Diseases.2013;20(1):1-8.

PURPOSE: The purpose of this study is to investigate the clinical manifestations and antibiotic resistance of salmonellosis in children. METHODS: We reviewed medical records and investigated the clinical characteristics of culture-proven childhood salmonellosis from January 2000 through December 2011 at the CHA Bundang Medical center. RESULTS: We assessed 53 patients. The median age was 3-years-old (minimum 12 days, maximum 18-years-old) and the number of male patients was 33 (62.3%). It occurred most frequently in the summer (39%) and in 2001 (11 cases) however there was no case in 2009 and 2010. Salmonella typhi was isolated in 3 cases with septicemia. Antibiotic resistance to ampicillin was most frequently presented (30.2%) and 63.6% in serogroup B. No antibiotics resistance strains were cultured in patients with positive Salmonella typhi. Admitted patients from 2000 to 2011 were divided into 2 groups; group 1 from 2000 to 2005 and group 2 from 2006 to 2011. 40 cases belonged to group 1 and 13 cases were in the group 2. Group 2 showed more resistance to ampicillin than group 1 but without any statistical significance(25% vs. 38.5%, P=0.349). In group 1, the most common serotype was group D and in group 2, the most common serotype were group C and D. CONCLUSION: Salmonellosis in children was frequently occurred from 2000 to 2003 but decreased after 2004. There was no difference in clinical manifestations, serotypes and antibiotic resistances between the years.
Ampicillin ; Anti-Bacterial Agents ; Child ; Drug Resistance, Microbial ; Humans ; Male ; Medical Records ; Salmonella Infections ; Salmonella typhi ; Sepsis

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