We report a case of a 5-year-old girl who developed left hemiparesis and left facial palsy, 6 days after the initiation of fever and respiratory symptoms due to pneumonia. Chest radiography, conducted upon admission, showed pneumonic infiltration and pleural effusion in the left lung field. Brain magnetic resonance imaging showed acute ischemic infarction in the right middle cerebral artery territory. Brain magnetic resonance angiography and transfemoral cerebral angiography revealed complete occlusion of the right middle cerebral artery. Mycoplasma pneumoniae infection was identified by a 4-fold increase in IgG antibodies to M. pneumoniae between acute and convalescent sera by enzyme-linked immunosorbent assay. Fibrinogen and D-dimer levels were elevated, while laboratory exams in order to identify other predisposing factors of pediatric stroke were all negative. This is the first reported pediatric case in English literature of a M. pneumoniae-associated cerebral infarction involving complete occlusion of the right middle cerebral artery.
Antibodies ; Brain ; Causality ; Cerebral Angiography ; Cerebral Infarction ; Child, Preschool ; Enzyme-Linked Immunosorbent Assay ; Facial Paralysis ; Female ; Fever ; Fibrinogen ; Humans ; Immunoglobulin G ; Infarction ; Infarction, Middle Cerebral Artery ; Lung ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Middle Cerebral Artery* ; Mycoplasma pneumoniae* ; Mycoplasma* ; Paresis ; Pleural Effusion ; Pneumonia* ; Pneumonia, Mycoplasma* ; Radiography ; Stroke ; Thorax

We report a case of a 5-year-old girl who developed left hemiparesis and left facial palsy, 6 days after the initiation of fever and respiratory symptoms due to pneumonia. Chest radiography, conducted upon admission, showed pneumonic infiltration and pleural effusion in the left lung field. Brain magnetic resonance imaging showed acute ischemic infarction in the right middle cerebral artery territory. Brain magnetic resonance angiography and transfemoral cerebral angiography revealed complete occlusion of the right middle cerebral artery. Mycoplasma pneumoniae infection was identified by a 4-fold increase in IgG antibodies to M. pneumoniae between acute and convalescent sera by enzyme-linked immunosorbent assay. Fibrinogen and D-dimer levels were elevated, while laboratory exams in order to identify other predisposing factors of pediatric stroke were all negative. This is the first reported pediatric case in English literature of a M. pneumoniae-associated cerebral infarction involving complete occlusion of the right middle cerebral artery.
Antibodies ; Brain ; Causality ; Cerebral Angiography ; Cerebral Infarction ; Child, Preschool ; Enzyme-Linked Immunosorbent Assay ; Facial Paralysis ; Female ; Fever ; Fibrinogen ; Humans ; Immunoglobulin G ; Infarction ; Infarction, Middle Cerebral Artery ; Lung ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Middle Cerebral Artery* ; Mycoplasma pneumoniae* ; Mycoplasma* ; Paresis ; Pleural Effusion ; Pneumonia* ; Pneumonia, Mycoplasma* ; Radiography ; Stroke ; Thorax

PURPOSE: Allergic rhinitis (AR) is one of the most common childhood diseases in Korea. In this study, we aimed to investigate the prevalence and allergens of childhood AR in Gwangju. METHODS: From April 2013 to September 2013 in Gwangju, skin prick test and questionnaire survey were performed targeting 2,330 children in total (350 kindergartners, 930 elementary school students, 589 middle school students, and 461 high school students). RESULTS: The overall prevalence of AR was 23.5% (female 21.3%, male 26.1%). According to age groups, prevalence of AR was 14.9% (female 10.7%, male 19.8%) in kindergartners, 24.5% (female 18.8%, male 29.4%) in elementary school students, 23.3% (female 18.1%, male 27.6%) in middle school students, 26.2% (female 27.7%, male 23.2%) in high school students. The most common allergen was Dermatophagoides pteronyssinus (79.7%), followed by Dermatophagoides farina (72.2%), birch (14.0%), alder (12.0%), Japanese hop (9.2%), Alternaria (8.9%), cat fur (7.2%), Japanese cedar (6.9%), ryegrass (6.6%), willow (6.0%), pine (5.4%), oak (4.9%), mugwort (4.3%), orchard grass (4.0%), sheep fescue (3.7%), fat hen (3.4%), ragweed (3.4%), and maple (3.4%). CONCLUSION: This research figures out the prevalence and the detailed allergens of AR in Gwangju children. We suggest that more vegetation data of Japanese cedar should be surveyed in recent future.
Acer ; Adolescent* ; Allergens* ; Alnus ; Alternaria ; Ambrosia ; Animals ; Artemisia ; Asian Continental Ancestry Group ; Betula ; Cats ; Child* ; Cryptomeria ; Dactylis ; Dermatophagoides pteronyssinus ; Gwangju ; Humans ; Humulus ; Korea ; Lolium ; Male ; Prevalence* ; Pyroglyphidae ; Rhinitis* ; Salix ; Sheep ; Skin ; Surveys and Questionnaires

PURPOSE: The characteristics of allergic rhinitis can be different among countries and areas because causative allergens and aggravating factors depend on the living environment. However, there have been few studies on the clinical feature of Korean children with allergic rhinitis, as well as on clinical characteristics in different age groups. The aim of this study was to investigate the clinical characteristics of Korean children with allergic rhinitis. METHODS: The medical records of children under 12 years of age who had rhinitis symptoms were analyzed in terms of clinical symptoms and positive allergens. Subjects were classified into 2 groups: those with allergic rhinitis (AR group) and nonallergic rhinitis (NAR group). Both groups were subdivided into 3 categories: the 1-4 years, 5-8 years, and 9-12 age groups. RESULTS: Among 516 children, 397 (76.94%) belonged to the AR group and 119 (23.06%) belonged to the NAR group. The male to female ratios were 2:1 in both groups. There were significant differences in sneezing and itching between the AR and NAR groups across different age subgroups. There were significant differences in nasal obstruction between the AR and NAR groups in the 9-12 age group. The incidence of AR was 77.8 % in chronic sinusitis patients. Sensitized allergens were house dust mites, animal hair, pollen, and mold in decreasing order in the AR group. Children who were sensitized to animal hair more frequently had sneezing than those who were not. CONCLUSION: Sneezing and itching strongly suggest allergic rhinitis in Korean children. Clinical characteristics of allergic rhinitis in Korean children would helpful in early diagnosis and adequate treatment of disease.
Allergens ; Animals ; Child* ; Early Diagnosis ; Female ; Fungi ; Hair ; Humans ; Incidence ; Male ; Medical Records ; Nasal Obstruction ; Pollen ; Pruritus ; Pyroglyphidae ; Rhinitis* ; Sinusitis ; Sneezing

PURPOSE: Korean children have their own unique lifestyle based on their living environment and culture. This study aimed to develop a questionnaire to evaluate the quality of life in Korean children with allergic rhinitis. METHODS: After a preliminary survey, an initial questionnaire was developed. Questions were modified to be easily understood by young children aged 6 to 7 years. The modified questionnaire was tested on children aged 6 to 12 years old. Item scores, defined as the proportion of children whose answer score was 1 point or higher was multiplied by the average answer score of each question, were used to identify questions that have practical application to the quality of life in Korean children with allergic rhinitis. Differences in answer scores between children with allergic rhinitis and those who were healthy were assessed by a Wilcoxon rank-sum test. The relationship between nasal index scores and quality of life scores was determined by a Spearman rank order test. RESULTS: An initial questionnaire was composed of 21 items. We identified 19 questions with item scores above 0.5 in children with allergic rhinitis, many of which were related to nasal symptoms and 10 questions that were different between the allergic rhinitis group and the control group. The final questionnaire included the 10 questions that had both high item scores and a significant difference in the answer scores between the two groups. CONCLUSIONS: The developed questionnaire is essential and practical for assessing discomfort related to the symptoms felt by Korean children with allergic rhinitis.
Child* ; Humans ; Life Style ; Quality of Life* ; Rhinitis* ; Surveys and Questionnaires

PURPOSE: This study was aimed to evaluate the clinical features of hypoxic ischemic encephalopathy(HIE) in children with and without seizures. METHODS: Fifty five children who had been diagnosed as HIE at Inha University Hospital from June 1999 to December 2011 were enrolled in this study. Subjects were divided into two groups by the presence of seizures and their medical records were retrospectively analyzed. RESULTS: Among the 55 cases, 34 patients (61.8%) had seizures, while 17 patients (32.2%) did not have them. Male to female ratio was 1:1 for the 'seizure' group and 2.5:1 for the 'no seizure' group. The onset age was 9.7 months (range: 0-158 months) for the 'seizure' group and 10 months (range : 0-108 months) for the 'no seizure' group. The most common risk factor was birth asphyxia (17.7%) for the 'seizure' group, and prematurity (23.8%) for the 'no seizure' group. The most common symptom other than seizure was respiratory arrest for both groups. On radiologic imaging studies of the brain, main causative lesion was most commonly observed in the cerebral cortex in both groups. The neurologic deficits or death were detected in 67.7% of the 'seizure' group, and 76.3% of the 'no seizure' group. There were no statistically significant differences in risk factors between the two groups. CONCLUSION: Although the characteristics between patients with and without seizures from HIE revealed no significant differences, HIE still can result in death or permanent disability in children. Therefore, permanent brain damage may be minimized by early suspicion and treatment in these patients.
Age of Onset ; Asphyxia ; Brain ; Cerebral Cortex ; Child* ; Female ; Humans ; Hypoxia-Ischemia, Brain* ; Male ; Medical Records ; Neurologic Manifestations ; Parturition ; Retrospective Studies ; Risk Factors ; Seizures*

Toxic epidermal necrolysis (TEN) is the most severe form of skin reactions caused by drugs or infection. Acute pulmonary complications in TEN are often observed. The mortality is especially high in those who suffer chronic pulmonary complications of TEN such as bronchiolitis obliterance, which occur as a consequence of bronchial epithelial injury. We report a case of a 16-year-old male who had required mechanical ventilation due to acute respiratory distress syndrome caused by TEN at 8 years of age. Although the patient initially recovered from acute respiratory distress syndrome, he required mechanical ventilation again due to severe chronic pulmonary complications of bronchiolitis obliterance and bronchiectasis caused by respiratory epithelial detachment. Thereafter, chronic bronchitis and chronic sinusitis has persisted due to mucosal ciliary dysfunction and several episodes of spontaneous pneumothorax has occurred. However, despite these persisting and serious sequelae of TEN, the patient has survived for 8 years. We report a rare case of a patient with long-term chronic pulmonary complications who had previously suffered TEN 8 years ago.
Adolescent ; Bronchiectasis ; Bronchiolitis ; Bronchitis, Chronic ; Epidermal Necrolysis, Toxic* ; Humans ; Male ; Mortality ; Pneumothorax ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult ; Sinusitis ; Skin

PURPOSE: The diagnosis of allergic rhinitis (AR) is based upon the concordance between a history of allergic symptoms and diagnostic tests. This study is to investigate the epidemiology of AR by using data from National Health Insurance Corporation (NHIC) and data according to the AR definition in general students health screening. METHODS: We examined medical insurance claims data of NHIC from 2004 to 2010 according to age, area, and gender. We investigated the results of Korean International Study of Asthma and Allergies in Childhood questionnaires and skin prick tests of 14,133 students participated in health screening from 2010 to 2012. RESULTS: The prevalence of AR according to the NHIC data was elementary school students (24.34%); middle school students (13.75%) and high school students (12.17%). The prevalence of AR was higher in boy than in girl, annually. In health screening, the prevalence of AR was elementary school students (19.50%+/-0.26); middle school students (23.19%+/-0.30) and high school students (24.11%+/-0.31). The prevalence of AR had peaking at the age late teens (P<0.0001) and was higher in boy (26.49%+/-0.38) than in girl (17.43%+/-0.35) (P<0.0001). Sensitization rate of allergen in students with AR was house dust mite (86.71%+/-0.48); pollen (41.26%+/-1.01) and molds (14.80%+/-0.52). CONCLUSION: The prevalence according to the AR definition tended to be increased with aging in Korean children. There are some differences in the prevalence of AR in the data of NHIC and health screening study. Further investigation will be needed to reveal the causes of this difference.
Adolescent ; Aging ; Asthma ; Child* ; Diagnosis ; Diagnostic Tests, Routine ; Epidemiology* ; Female ; Fungi ; Humans ; Hypersensitivity ; Insurance ; Male ; Mass Screening ; National Health Programs ; Pollen ; Prevalence ; Pyroglyphidae ; Rhinitis* ; Skin ; Surveys and Questionnaires

PURPOSE: We investigated the risk factors related to the development and aggravation of allergic rhinitis, which is associated with residential environment and lifestyle habits of children residing in Incheon. METHODS: A total of 182 children diagnosed with moderate to severe allergic rhinitis and 67 healthy children were enrolled. A detailed questionnaire of the environmental characteristics and the dietary habits were completed by the parents. Further, skin prick tests with 14 common allergens were performed. RESULTS: The mean age of the children with allergic rhinitis and healthy control was 8.2+/-2.8 and 9.4+/-2.0 years, respectively. The presence of indoor mold was associated with an increased risk of development of allergic rhinitis. (adjusted odds ratio [aOR], 4.26; 95% confidence interval [CI], 1.96-9.27) Among the food groups, there was no significant difference of the daily intake of milk and yogurt between the patients and the controls. However, daily intake of vegetables, except Kimchi, and daily intake of fruits or fruit juice were associated with a decreased risk of allergic rhinitis. (aOR, 0.43; 95% CI, 0.20-0.92 / aOR, 0.43; 95% CI, 0.13-0.90, respectively) CONCLUSION: The results indicate that an indoor dampness is one of the risk factors of development and aggravation of allergic rhinitis. Control of indoor humidity and daily intake of fruits and vegetables can prevent the development and control symptoms of allergic rhinitis.
Allergens ; Child ; Diet ; Food Habits ; Fruit ; Fungi ; Humans ; Humidity ; Life Style ; Milk ; Odds Ratio ; Parents ; Surveys and Questionnaires ; Rhinitis ; Rhinitis, Allergic, Perennial ; Risk Factors ; Skin ; Vegetables ; Yogurt

PURPOSE: It is widely known that allergic diseases progress through a sequential course known as the allergic march. However, there have been no recent reports in Korea regarding the progress of allergic diseases based on the medical claim data of the National Health Insurance Corporation. METHODS: Medical claim data of 2005 and 2008 from the National Health Insurance Corporation were used. Data was classified according to the administrative districts of metropolitan cities and provinces, and divided according to age in increments of 5 years. RESULTS: According to the nationwide survey on the prevalence of allergic diseases according to region, the prevalence of allergic diseases increased in 2008 compared to 2005. Especially, the prevalence of allergic rhinitis significantly rises in all regions. When comparing the prevalence of allergic diseases according to age, there was no significant difference in the prevalence of atopic dermatitis and asthma between 2005 and 2008. In contrast, allergic rhinitis demonstrated a rise of more than 5% in all age groups. CONCLUSION: According to the nationwide survey on the prevalence of allergic diseases using the medical claim data from the National Health Insurance Corporation, the prevalence of allergic rhinitis had significantly increased in 2008 compared to 2005. More survey studies should be conducted in the future using the medical claim data of the National Health Insurance Corporation.
Asthma ; Dermatitis, Atopic ; Korea ; National Health Programs ; Prevalence ; Rhinitis ; Rhinitis, Allergic, Perennial