ABSTRACT
PURPOSE: The mortality rate of neonatal sepsis has been decreased, however, the incidence has not significantly decreased because of increased invasive procedures. This study was designed to make guidelines for choosing antibiotics by analyzing the causative microorganisms and their antibiotics sensitivity test according to the onset of neonatal sepsis. METHODS: One hundred seven cases of culture proven sepsis in 89 patients admitted to the NICU of Chonnam University Hospital from Jan. 2000 to Dec. 2004, were enrolled. By reviewing the medical records, clinical data, laboratory findings, causative organisms and their antibiotics sensitivity, and mortality were analyzed. RESULTS: The incidence of neonatal sepsis was 1.7 percent and more prevalent in premature and low birth weight infants. 85.4 percent of neonatal sepsis was late onset. Almost all microorganisms(92.9 percent) were gram-positive in early onset, however, two thirds were gram-positive and one third were gram-negative and Candida in late onset. Gram-negative organisms and Candida were more prevalent in patients who had central line. Gram-positive organisms were sensitive to vancomycin, teicoplanin, and gram-negative were sensitive to imipenem, and cefotaxime. CONCLUSION: Neonatal sepsis was more prevalent in premature and low birth weight infants. More than 90 percent were gram-positive in early onset, however, one third was gram-negative and Candida in late onset. The first choice of antibiotics were a combination of third generation cephalosporin and clindamycin in early onset, and third generation cephalosporin and glycopeptide in late onset. If there is no response to antibiotics treatment, the use of antifungal agents should be considered.
Subject(s)
Humans , Infant , Infant, Newborn , Anti-Bacterial Agents , Antifungal Agents , Candida , Cefotaxime , Clindamycin , Imipenem , Incidence , Infant, Low Birth Weight , Medical Records , Mortality , Sepsis , Teicoplanin , VancomycinABSTRACT
PURPOSE: To evaluate the morbidity and mortality of children with status epilepticus(SE) as an initial seizure and to compare these according to age groups. METHODS: The 78 cases(38 cases or = 2 years) with SE as an initial seizure admitted to the Chonnam national university hospital from Jan. 2000 to Jan. 2004 were reviewed. Developmental profiles, laboratory findings, etiologies and seizure types of SE and outcomes were compared in between two age groups, under and over 2 years. RESULTS: SE occurred predominantly in less than 5 years old. Febrile causes were the most common, which is significantly more in those under 2 years than over 2 years(P or = 2 years). The estimated occurrence of epilepsy after SE was 24.4 percent(19 cases:8 cases or = 2 years). The neurologic sequelae after SE in cases that had developed normally before SE(62 cases:32 cases or = 2 years) were observed in 20 cases(32.3 percent), and were more frequent over 2 years(21.9 percent vs. 43.3 percent, P<0.05). CONCLUSION: In this study death was less common and the neurologic sequelaes of SE as an initial seizure were less severe in children under 2 years of age. The reason seemed to be the difference in the etiology of SE with age.
Subject(s)
Child , Child, Preschool , Humans , Epilepsy , Mortality , Seizures , Status EpilepticusABSTRACT
PURPOSE: Cholestatic liver disease is a frequent complication of prolonged parenteral nutrition, especially in premature infants. The purpose of present study is to evaluate the clinical and biochemical efficacy of ursodeoxycholic acid (UDCA) in premature infants with total parenteral nutrition (TPN) cholestasis. METHODS: Retrospective chart review of 31 prematures with TPN cholestasis in Neonatal Intensive Care Unit of Chonnam University Hospital from January 1995 and December 2002 was done. Prematures were divided into two groups based on UDCA treatment: the study group (n=22, with UDCA treatment) and the control group (n=9, without UDCA treatment). Treatment efficacy of UDCA was evaluated by monitoring the changes of serum direct bilirubin level for more than one to two months. RESULTS: In study group, cholestasis appeared at a mean age of 23+/-18.8 days after a mean of 21+/-19.7 days of TPN. UDCA was initiated (ranged 15-30 mg/kg/day) at a mean age of 54+/-22.3 days for a mean of 32+/-19.0 days. There was no significant difference in decrease of direct bilirubin level between the study and control group. However, the day of initial enteral feeding and full enteral feeding were earlier in control group compared with study group. CONCLUSIONS: This study shows that UDCA treatment is not effective in the treatment of TPN cholestasis among premature infants unlike that of results reported in children and adults. To reduce the incidence of TPN cholestasis in premature infants, early introduction of enteral feeding as soon as possible is most important.
Subject(s)
Adult , Child , Humans , Infant, Newborn , Bilirubin , Cholestasis , Enteral Nutrition , Incidence , Infant, Premature , Intensive Care, Neonatal , Liver Diseases , Parenteral Nutrition , Parenteral Nutrition, Total , Retrospective Studies , Treatment Outcome , Ursodeoxycholic AcidABSTRACT
No abstract available.
Subject(s)
Humans , Infant , Infant, Newborn , Fetal Weight , Infant, Low Birth Weight , Parturition , Weight GainABSTRACT
Protein, and essential nutrient for the growth of children, is the chief nitrogenous substant in the serum of humans. For the purpose of establishment of the normal data for evaluation of nitrogen balance, we examined the serum levels of urea nitrogen, creatinine, uric acid and serum amylase activity as well as that of protein in 560 normal school children. The results are as follows; 1. The serum level of protein is 6.1+/-0.75mg%, albumin; 3.9+/-0.57gm%, globulin ; 2.2 +/- 0.77gm%, urea nitrogen ; 14+/-3.8mg%, creatinine; 0.5+/-0.20mg%, uric acid; 3.9+/-0.91mg%, and the serum amylase activity is 127+/-41.4% units/dl. And the reference rnage of the above data is 4.6~7.6gm%, 3.3~4.4mg%, 1.5~3.0gm%, 7~22 mg%, 0.3~0.7mg%, 2.1~5.7mg% and 45~210 units/dl, respectively. 2. There is evidence of age relationship in the serum level of urea nitrogen which tends to increase with age. 3. We observed sex differences in the serum levels of total protein and albumin examined and those of urea nitrogen and creatinine examined, female was predominant in the former and male in the latter.
Subject(s)
Child , Female , Humans , Male , Amylases , Creatinine , Nitrogen , Sex Characteristics , Urea , Uric AcidABSTRACT
We experienced a case of cryptococcosis in a 13-year-old female who had been admitted to our hospital because of intermittent high fever and generalized lymphadenopathy accompanied by multiple nodular eruptions with erosions on the face, scalp, neck and back. The patient was treated under the impression of tuberculous lymphadenitis without any improvement. A surgical biopsy of the lymph node and the subcutaneous nodule, which was performed 14 days later, revealed chronic granulomatous tissue and Langhan's type giant cells which contained numerous cryptococci. A brief review of the literature was done.
Subject(s)
Adolescent , Female , Humans , Amphotericin B , Biopsy , Cryptococcosis , Fever , Flucytosine , Giant Cells , Lymph Nodes , Lymphatic Diseases , Neck , Scalp , Tuberculosis, Lymph NodeABSTRACT
Pneumomediastinum, pneumothorax and subcutaneous emphysema are uncommon in pediatric practice, but they may be rarely ocured in association with respiratory distress and excessive ressusciation in the neonatal period, and as a complication of bronchial asthma, measles in childhood. And also, there was a report of a few cases that developed to pneumomediastinum and subcutaneous emphysema caused by vomiting in patient of diabetic coma. It is rare so far in this country that above events are complicated by miliary tuberculosis, but they may lead the patient to fatal and lifethreatening conditions, even though we perform a considerable medical treatment for that. We presnted 3 cases of 6 month 20 days old female infant, and each 10 year and 11 year old boys, developed to pneumomediastinu, pneumothorax and subcutaneous emphysema, and suddenly expired during hospital treatment of miliary tuberculosis. And, we reviewed the literatures, too.
Subject(s)
Child , Female , Humans , Infant , Asthma , Diabetic Coma , Measles , Mediastinal Emphysema , Pneumothorax , Subcutaneous Emphysema , Tuberculosis, Miliary , VomitingABSTRACT
A case of chylothorax and chylous ascites in a 10-year-old female patient who was admitted to the department of pediatrics because of abdominal distension, generalized edema and anorexia for 2 months, was described. Clinical study and review of literature were presented briefly.