A Comparative Study of Red Blood Cell Indices and Anemia by Feeding Patterns

PURPOSE: Iron-deficiency anemia is the most common nutritional deficiency in young infants. This study was designed to determine feeding patterns in infants, and determine a correlation between feeding patterns and incidence of anemia. METHODS: This study was conducted by taking blood tests (hemoglobin, hematocrit, and red cell indices) by venipuncture with the electronic counters from 221 infants aged 9-12 months old, who came to Well Baby Clinics in the Department of Pediatrics, Seoul Sacred Heart Hospital for a health check-up. Their mothers answered a questionnaire regarding their feeding patterns. RESULTS: The 221 infants aged 9-12 months, were divided into three groups, i.e. infants who were exclusively breast-fed(group A=6.8%), those who had been given mixed feeding or breast milk for 2 months and then switched to artificial formula milk(group B=22.6%), and those who had been given artificial formula milk since birth(group C=70.6%). Of the 221 infants, 7 infants(3.2 %) were found to have iron deficiency anemia. Infants with anemia comprised 20.0%(3/15) of group A, significantly more than the 2.0(1/50) of group B and 1.9%(3/156) of group C(P<0.005). CONCLUSION: The incidence of iron-deficiency anemia was 3.2%, which was lower than previous reports, as 93.2% of the infants studied were from middle-class families. Seven infants with iron deficiency anemia were found to have been insufficiently fed with iron-rich weaning foods. Thus, studying the feeding patterns of infants is highly predictive of their risk for anemia. Therefore, regular blood tests on infants at high risk for anemia is recommended, as well as supplementary feeding of iron-fortified foods.

Percutaneous drainage of splenic abscess in typhoid fever: a case report

Salmonella typhi splenic abscesses are a very rare complication of typhoid fever. Splenectomy is the standard surgical treatment for these lesions. But these days, with improvements in imaging techniques, percutaneous drainage of splenic abscesses has been demonstrated to be one of the alternative treatment in selected cases. We report the case of a 7 year-old male, who presented with Salmonella typhi in blood and urine cultures, and a 1: 320 in O titer of Widal test. Ultrasound and computed tomography showed a single splenic abscess, 3 cm in diameter. He was treated with antibiotics, but the symptoms were not relieved. Thus we performed the percutaneous drainage of the splenic abscess under ultrasound guidance. A culture of the aspirated material was positive for Salmonella typhi, and the boy's condition improved. We think that percutaneous drainage of a single lesion was an excellent alternative to surgery, particularly because our patient was young and spleen conservation was desirable.

Acute Tubular Necrosis Associated with Typhoid Fever

Acute tubular necrosis has been rarely reported as a complication of typhoid fever in the literature. We experienced four cases of acute tubular necrosis associated with typhoid fever in children. Patients showed significant titer of widal reaction associated with acute renal failure and one of them rised in 2 months after onset of clinical symptoms. Renal biopsy findings were compatible with acute tubular necrosis and immune complexes were not deposited in the glomeruli. Clinical and urinary findings were normalized by hemodialysis and antibiotic therapies. In conclusion, close longterm follow up of widal titer is mandatory in acute tubular necrosis, especially when associated with high fever.

Pulmonary Artery Sling with Situs Solitus Dextroposition of Heart and Left Superior Vena Cava

Pulmonary artery sling is a rare congenital cardiovascular anomaly which presents clinical obstructive symptoms and signs of trachea, right main bronchus and esophagus due to left pulmonary artery abnormaly arises from proximal part of right pulmonary artery. Aberrant left pulmonary artery courses to the right above right main bronchus and then turns to the left, and courses to between the anterior of the esophagus and the posterior aspect of trachea. One of important clinical significances of the pulmonary artery sling is associated with intracardiac anomalies, and with tracheal stenosis and bronchomalacia due to press tracheobronchial tree by the aberrant pulmonary artery. It has been thought that embryological malconnection between the pulmonary artery bud from left sixth arch and the pulmonary posterior branchial plexus in the left lung bud. We had experienced 21 months old male infant with left pulmonary artery sling associated with persistent left superior vena cava and dextropostioned heart. The heart seems to move to right hemithorax due to hypoplasia or segmental atelectasis of right lung.