Clinical Features and Prognostic Factors of Neurologic Outcome in Group B Streptococcal Meningitis / 대한소아신경학회지

PURPOSE: Group B streptococcal (GBS) meningitis is the leading cause of mortality and morbidity in neonates. There are limited current data regarding outcomes from GBS meningitis and factors that predict an adverse outcome. METHODS: Twenty-three cases of GBS meningitis that were proven by cerebrospinal fluid culture from 2000 to 2010 were retrospectively reviewed. RESULTS: All GBS meningitis cases occurred in young infants less than 3 months and were late-onset (> or =7 days). Four infants (17.4%) died, and three (13.0%) were neurologically impaired at hospital discharge. Compared to the 16 infants with normal neurologic examinations, the 7 infants who died or had adverse outcomes at hospital discharge were more likely to present with seizures within hours of admission, have coma, require pressor support or ventilator support, have an initial peripheral blood leukocyte count less than 4,000/mm3 or neutrophil count less than 1,000/mm3, and have ampicillin resistance on culture. CONCLUSION: Despite advances in intensive care, 30.4% of infants with GBS meningitis die or have neurologic impairment at hospital discharge. Poor outcome can be predicted in cases that have seizures, coma, peripheral leukopenia, or require ventilator or pressor support on initial presentation. These cases show a tendency toward resistance to ampicillin, so vancomycin can be tried initially.

Comparison of Clinical Manifestations of RSV, Rhinovirus and Bocavirus Infections in Children with Acute Wheezing / 소아알레르기및호흡기학회지

PURPOSE: The purpose of this study was to compare clinical manifestations of human bocavirus (hBoV), respiratory syncytial virus (RSV), and human rhinovirus (hRV) in children with acute wheezing. METHODS: We retrospectively investigated 549 virus-positive throat swabs obtained between January 2006 and December 2008 from pediatric inpatients with acute respiratory tract disease at Kwangju Christian Hospital. Among them, 109 patients, who had lower respiratory tract infections with wheezing, were enrolled in this study. The medical records of patients with positive results were reviewed for clinical data. RESULTS: The mean age of the patients with RSV was 7.15 months, 15.66 months in those with hRV, and 15.04 months in those with hBoV. The mean fever duration and frequency of patients with fever was 2.43 days and 47.9% for RSV, 2.86 days and 51.7% for hRV, and 3.75 days and 69.6% for hBoV. The frequency of patients with acute otitis media was 20.8% in the RSV, 20.7% in the hRV, and 13.0% in the hBoV groups. The frequency of lung infiltration on chest X-ray was 12.5% in the RSV, 20.7% in the hRV, and 47.8% in the hBoV groups. CONCLUSION: We compared the clinical manifestations of respiratory viral infections in infants and children with wheezing. However, further surveillance will be necessary to clarify the clinical manifestations of the viruses.