ABSTRACT
Background/Aims@#Small intestinal bacterial overgrowth (SIBO) is expected in children and adolescents with functional abdominal pain disorders (FAPDs). This study is conducted to estimate the prevalence of SIBO and to investigate the role of SIBO in children and adolescents with FAPDs. @*Methods@#This prospective study enrolled children with FAPDs fulfilling the Rome IV criteria. A hydrogen-methane glucose breath test was used to diagnose SIBO. A survey of bowel symptoms using questionnaires, birth history, types of feeding, and the presence of allergy was conducted. @*Results@#Sixty-eight children and adolescents (range, 6-17 years; median, 12.5 years) were enrolled. SIBO was detected in 14 patients (20.6%). Age (≥ 12 years) (P < 0.003) and loose stool (P = 0.048) were significantly more common in children with SIBO than in children without SIBO. However, the history of allergies (P = 0.031) was less common in children with SIBO than those without SIBO. No significant differences were observed in other demographic findings. In multivariate analysis, age (≥ 12 years) was the independent factor predicting SIBO in children with FAPDs. @*Conclusions@#SIBO is not uncommon in children and adolescents with FAPDs. Among children aged above 12 years and diagnosed with FAPDs, SIBO is a suspected clinical target for treatment to relieve intestinal symptoms. A further study to investigate the association between intestinal bacteria and history of allergy is needed.
ABSTRACT
Ascariasis is the most common helminthic infection in humans. However, its prevalence has been very low in Korea since the 1990s. Recently, there have been several case reports on intestinal obstruction or pancreaticobiliary disease due to infection with Ascaris lumbricoides in adults. However, cases of ascariasis in children have rarely been reported in Korea. We report a case of ascariasis in a 2-year-old boy who experienced expulsion of an adult ascaris worm from his anus. His mother found the worm in his diaper in the morning. His medical history was nonsignificant for any previous illnesses. There were no specific symptoms, and no abnormal findings were found on physical examination. The worm was pink, elongated, and cylindrical; it was 25 cm long and 5 mm wide. Unfertilized eggs of A. lumbricoides were detected in his stool specimen. He was treated with albendazole and remained asymptomatic at follow-up. As long as the number of immigrants from endemic areas and people returning from overseas trips, and import of agricultural products keep increasing, ascariasis can still occur in Korea. Therefore, it is necessary to raise awareness regarding ascariasis.
ABSTRACT
Actinomyces are anaerobic, Gram-positive bacteria that are part of the endogenous flora of mucous membranes in humans. Infection caused by these bacteria is termed actinomycosis. The 3 most common types of actinomycosis are cervicofacial, abdominopelvic, and pulmonary. A previously healthy 6-year-old boy presented with the emergency room with fever, vomiting, and abdominal pain and initially diagnosed with acute appendicitis. Exploratory laparoscopy was done. Histologic finding demonstrated acute gangrenous appendicitis complicated by perforation and sulfur granules compatible with actinomycosis. Subsequently, he was diagnosed with abdominal actinomycosis and received long-term antibiotic therapy. Abdominal actinomycosis is uncommon in children and difficult to diagnose because of its nonspecific symptoms and of difficulties in growing Actinomyces in the clinical setting. It is necessary to include abdominal actinomycosis as a differential diagnosis of children presenting with abdominal pain.