The recent epidemic of Zika virus in South America caused people around the world to exhibit an increased interest in the impact of arboviral illnesses. In Korea, malaria and Japanese encephalitis are the most important mosquito-borne diseases that occur indigenously. However, with the continuously increasing number of international travelers, the incidence of imported arboviral illnesses is also increasing. Currently, dengue fever is the most common mosquito-borne disease among Korean international travelers. The number of patients with Japanese encephalitis, chikungunya fever, and Zika virus infection is also on the rise. Many countries that have disease-transmitting mosquitoes have already experienced autochthonous arboviral infections due to the introduction of viruses by travelers. Moreover, with global warming and urbanization of the areas in which mosquito-borne diseases occur, the environment is becoming more favorable for mosquito-borne diseases. This concise review describes the current status and outlook of mosquito-borne diseases in Korea.
Chikungunya Fever ; Culicidae ; Dengue ; Encephalitis, Japanese ; Global Warming ; Humans ; Incidence ; Korea* ; Malaria ; South America ; Urbanization ; Zika Virus ; Zika Virus Infection

In light of global climate change, the seasonal and geographical distribution of vector species, especially mosquitoes, chigger mites, and ticks, are of great importance for human beings residing in rural and urban environments. A total of 12 species belonging to 4 genera have been identified as vector mosquitoes in the Republic of Korea. The most common of the 56 mosquito species in this country from 2013 through 2015 was found to be a malaria vector, Anopheles sinensis s.l. (species ratio [SR] 52%); followed by a potential vector of West Nile virus, Aedes vexans nipponii (SR 38%); a Japanese encephalitis vector, Culex tritaeniorhynchus (SR 6%); a West Nile virus vector, Culex pipiens (SR 3%); and a dengue and Zika virus vector, Ae. albopictus (SR 0.3%). Of the scrub typhus vectors, Leptotrombidium scutellare is the predominant chigger mite in Gyongnam province and Jeju island, whereas L. pallidum is the predominant species in other areas of Korea. Ticks were found to be prevalent in most environmental conditions, and high levels of their activity were consistently observed from May to September. Haemaphysalis species of ticks were mostly collected in grasslands, whereas Ixodes species were frequently found in coniferous forests. Haemaphysalis longicornis, known as the main vector of severe fever with thrombocytopenia syndrome, was the predominant species and was widely distributed throughout the country.
Aedes ; Anopheles ; Climate Change ; Communicable Diseases* ; Coniferophyta ; Culex ; Culicidae ; Dengue ; Disease Vectors* ; Encephalitis, Japanese ; Fever ; Forests ; Globus Pallidus ; Grassland ; Humans ; Ixodes ; Korea* ; Malaria ; Mites ; Republic of Korea ; Scrub Typhus ; Seasons ; Thrombocytopenia ; Ticks ; Trombiculidae ; West Nile virus ; Zika Virus

The incidence of vector-borne diseases has increased with climate change and developments of transportation. Malaria was eliminated in the early 1980s in Korea, but one domestic case was reported in 1993. The number of patients increased to 4,142 in 2002, and less than 700 cases of malaria are reported annually nowadays. Additionally, approximately 70 to 80 imported malaria cases were reported annually, and most of them are Plasmodium falciparum infections from Africa. Annually, 20 to 40 cases of Japanese encephalitis are reported, and the incidence is high in individuals between the ages of 40 and 59. Moreover, 313 cases of dengue fever were imported in 2016, and most of them were from Southeast Asia. In 2016, 11,000 cases of scrub typhus were reported, and most of the patients were older than 50. The number of reported cases of severe fever with thrombocytopenia syndrome has been increasing since 2013, mostly in patients older than 60. It is important to avoid vectors for the prevention, and for the doctors to diagnose the apatients as soon as possible.
Africa ; Asia, Southeastern ; Climate Change ; Dengue ; Encephalitis, Japanese ; Fever ; Humans ; Incidence ; Korea ; Malaria ; Plasmodium falciparum ; Scrub Typhus ; Thrombocytopenia ; Transportation

PURPOSE: This study aimed to investigate whether serum neuron-specific enolase (NSE) was expressed in acute encephalitis syndrome (AES) that causes neuronal damage in children. METHODS: This prospective observational study was conducted in the pediatric neurology ward of Soetomo Hospital. Cases of AES with ages ranging from 1 month to 12 years were included. Cases that were categorized as simple and complex febrile seizures constituted the non-AES group. Blood was collected for the measurement of NSE within 24 hours of hemodynamic stabilization. The median NSE values of both groups were compared by using the Mann-Whitney U test. All statistical analyses were performed with SPSS version 12 for Windows. RESULTS: In the study period, 30 patients were enrolled. Glasgow Coma Scale mostly decreased in the AES group by about 40% in the level ≤8. All patients in the AES group suffered from status epilepticus and 46.67% of them had body temperature >40℃. Most of the cases in the AES group had longer duration of stay in the hospital. The median serum NSE level in the AES group was 157.86 ng/mL, and this value was significantly higher than that of the non-AES group (10.96 ng/mL; P<0.05). CONCLUSION: AES cases showed higher levels of serum NSE. These results indicate that serum NSE is a good indicator of neuronal brain injury.
Body Temperature ; Brain Injuries ; Child ; Encephalitis* ; Glasgow Coma Scale ; Hemodynamics ; Humans ; Neurology ; Neurons* ; Observational Study ; Phosphopyruvate Hydratase* ; Prospective Studies ; Seizures, Febrile ; Status Epilepticus

PURPOSE: This study is aimed to evaluate the effectiveness and tolerability of rufinamide as add-on therapy in patients with intractable epilepsies. METHODS: We retrospectively reviewed the medical records of 70 patients treated with rufinamide in Asan Medical Center, children's hospital. Two cases with incomplete medical records were excluded and total sixty-eight cases were enrolled. Rufinamide was added on the existing antiepileptic drugs and the total seizure frequency at pre-medication, 3 months and 12 months were examined. RESULTS: The mean age of 68 patients (43 male) was 10.5 yrs (range, 1-24 yrs). At 3 months after rufinamide initiation, 5 patients achieved freedom from seizures and 28 (41.2%) achieved a ≥50% seizure reduction. At 12 months, 7 patients achieved seizure freedom and 29 (42.6%) achieved ≥50% seizure reduction. The retention rate was hold up to 75.0% at 3 months and 66.2% at 12 months of study. Total 29 patients reported adverse events in order of seizure aggravation, somnolence, insomnia, common cold, nausea and vomiting. CONCLUSION: In this study, rufinamide is effective and tolerable in patients with other intractable epilepsy of childhood onset as well as the patients with LGS. Further research is required to define the efficacy of rufinamide in intractable epilepsy other than LGS.
Anticonvulsants ; Chungcheongnam-do ; Common Cold ; Drug Resistant Epilepsy ; Encephalitis, Viral* ; Freedom ; Humans ; Medical Records ; Nausea ; Retrospective Studies ; Seizures ; Sleep Initiation and Maintenance Disorders ; Vomiting

Coxsackievirus A16 (CA16), which primarily causes hand, foot, and mouth disease (HFMD), is associated with complications, such as encephalitis, acute flaccid paralysis, myocarditis, pericarditis, and shock. However, no case of pancreatitis associated with CA16 has been reported in children. We report a case of CA16-associated acute pancreatitis in a 3-year-old girl with HFMD. She was admitted because of poor oral intake and high fever for 1 day. Maculopapular rashes on both hands and feet and multiple vesicles on the soft palate were observed on physical examination. She was treated conservatively with intravenous fluids. On the fourth hospital day, she had severe abdominal pain and vomiting. The serum levels of amylase and lipase were remarkably elevated (amylase, 1,902 IU/L; reference range, 28–100 IU/L; lipase, >1,500 IU/L; reference range, 13–60 IU/L), and ultrasonography showed diffuse swelling of the pancreas with a small amount of ascites. The real-time reverse transcription polymerase chain reaction result from a stool sample was positive for CA16. CA16 can cause acute pancreatitis, and should be considered in the differential diagnosis of abdominal pain in children with HFMD.
Abdominal Pain ; Amylases ; Animals ; Ascites ; Child ; Child, Preschool ; Diagnosis, Differential ; Encephalitis ; Exanthema ; Female ; Fever ; Foot ; Foot-and-Mouth Disease ; Hand* ; Hand, Foot and Mouth Disease* ; Humans ; Lipase ; Mouth Diseases ; Myocarditis ; Palate, Soft ; Pancreas ; Pancreatitis* ; Paralysis ; Pericarditis ; Physical Examination ; Polymerase Chain Reaction ; Reference Values ; Reverse Transcription ; Shock ; Ultrasonography ; Vomiting

Relapsing polychondritis (RP) is a rare autoimmune disease that is characterized by inflammatory reaction of unknown etiology and destruction of cartilaginous structures. Characteristic symptoms of this disease include cartilage inflammation of the ear, nose, larynx, trachea, bronchi, joints, eyes, heart and skin. Concomitance with neurologic symptom is very rare in RP, and the detailed underlying mechanism of neurological involvement associated with RP is not fully understood. We herein described an unusual recurrent case of inflammatory brain lesions associated with RP, with attention to clinical manifestations, autoimmune disease involvement, and therapeutic effects.
Atrophy* ; Autoimmune Diseases ; Brain* ; Bronchi ; Cartilage ; Ear ; Encephalitis* ; Heart ; Inflammation ; Joints ; Larynx ; Multiple Sclerosis ; Neurologic Manifestations ; Neuromyelitis Optica ; Nose ; Polychondritis, Relapsing* ; Skin ; Therapeutic Uses ; Trachea

Autoimmune limbic encephalitis is a rare cause of encephalitic disease. It is associated with various target antigens and is difficult to diagnose, and experience with its treatment is limited. This case report describes a 69-year-old man, who presented with life-threatening hyponatremia and confusion, following several months of gradually worsening faciobrachial dystonic seizures. Faciobrachial dystonic seizures are a well-described feature classically observed in voltage-gated potassium channel autoimmune encephalitis. The presence of chronic hyponatremia without cognitive dysfunction, eventually culminating in an acute episode of encephalopathy and severe hyponatremia, is a pattern of natural history not previously documented in this condition.
Aged ; Brain Diseases ; Dystonia ; Encephalitis* ; Humans ; Hyponatremia* ; Limbic Encephalitis ; Natural History ; Potassium Channels, Voltage-Gated* ; Seizures*

Meningitis is a common central nervous system (CNS) complication of the mumps, a viral infection, but encephalitis and meningoencephalitis are less common in mumps. We describe magnetic resonance imaging findings of acute mumps meningoencephalitis in a 32-year-old male who showed bilateral hippocampal lesions without preceding parotitis. Although it is rare, hippocampal involvement should be considered a CNS complication of mumps infection.
Adult ; Brain ; Central Nervous System ; Encephalitis ; Hippocampus ; Humans ; Magnetic Resonance Imaging* ; Male ; Meningitis ; Meningoencephalitis* ; Mumps* ; Parotitis*

We report a case of a young female patient with catatonic features who later turned out to be suffering from an anti-NMDA (N-methyl-D-aspartate)-receptor-antibody encephalitis. A previously healthy 21-year-old woman was admitted to psychiatric inpatient care presenting with acute psychotic behavior with catatonic features. Laboratory tests of serum and CSF (Cerebrospinal fluid), EEG (Electroencephalogram), brain MRI (Magnetic Resonance Imaging) were unremarkable except vague slow wave on EEG. However, subtle cognitive impairment at the bedside examination suggested further imaging studies to rule out possible organic etiology like autoimmune encephalitis. Brain PET (Positron Emission Tomography) and SPECT (Single Photon Emission Computed Tomography) suggested probable inflammation in the brain. In case of autoimmune encephalitis, given the severity of symptoms and worsening course, steroid pulse therapy was initiated promptly even though the diagnosis was not confirmed but presumed at that time. She recovered completely with steroid therapy. Later her disease turned out to be anti-NMDA-receptor-antibody encephalitis by the antibody test which was not available at the time of admission. Psychiatrists need to be aware of autoimmune encephalitis like anti-NMDA-receptor-antibody encephalitis in the differential diagnosis of acute psychosis with catatonic features. Subtle cognitive impairment which tends to be overlooked due to catatonic features might be a clue to suspect the organic etiology.
Brain ; Catatonia* ; Cognition Disorders ; Diagnosis ; Diagnosis, Differential ; Electroencephalography ; Encephalitis* ; Female ; Glycogen Storage Disease Type VI ; Humans ; Inflammation ; Inpatients ; Magnetic Resonance Imaging ; N-Methylaspartate* ; Psychiatry ; Psychotic Disorders ; Tomography, Emission-Computed, Single-Photon ; Young Adult