Peritonsillar Abscess in a 40-Day-Old Infant

A peritonsillar abscess is one of the most commonly occurring deep space infections of the head and neck in adults and children. A peritonsillar abscess that appears in newborns, however, is extremely rare. The treatment of a peritonsillar abscess requires both the selection of appropriate antibiotics and the best procedure to remove the abscessed material. We report a case of a peritonsillar abscess in a 40-day-old infant who was treated with antibiotic therapy alone.

House Dust Endotoxin Exposure and Allergic Sensitization in Korean Home Living Conditions / 소아알레르기및호흡기학회지

PURPOSE: Household endotoxin exposure in allergy and asthma has been gaining attention for its dual potential to exacerbate these conditions in individuals with established disease and to abrogate atopy before disease onset. The aim of this work was to analyze associations between current exposure to bacterial endotoxin in house dust and allergic sensitization in adults with asthma. METHODS: From the homes of 52 adults with asthma and 28 normal controls, house dust endotoxin (detected with a Limulus Amebocyte Lysate QCL-1000) and house dust mite allergens (Der f 1 and Der p 1) were quantified. Allergen sensitization was measured by skin prick test. RESULTS: The endotoxin levels from mattresses were lower in the home of adults with asthma than in that of normal controls. The endotoxin levels from mattresses detected in the home of adults with asthma were positively correlated with Der p 1 levels and wheal size to housedust mite allergens on skin prick tests. Furthermore, the endotoxin levels in living room floor dust were positively correlated with Der f 1 levels, but didn't relate with wheal size to house dust mite allergens. CONCLUSION: Our results indicate that current exposure to house dust endotoxin might be positively associated with allergic sensitization in adults with asthma.

Increased Serum Thymus and Activation-regulated Chemokine (TARC) Levels in Children with Atopic Dermatitis / 소아알레르기및호흡기학회지

PURPOSE: Thymus and activation-regulated chemokine (TARC) is responsible for the trafficking of Th2 lymphocytes into sites of allergic inflammation. We tested whether TARC is a useful marker for childhood atopic dermatitis (AD) and we evaluated age-related differences in the level of TARC. METHODS: Serum TARC level, serum total IgE level, total eosinophil count and specific IgE level were measured in 401 children. They were characterized as having IgE-mediated atopic dermatitis (n=157), non-IgE mediated atopic dermatitis (n=107), or as healthy control subjects (n=137). RESULTS: TARC levels in AD significantly were higher than those in healthy control subjects. (152.9+/-11.6 vs 56.7+/-5.2 pg/mL, P< 0.05) Serum TARC levels significantly correlated with disease severity (SCORAD index) both in children with IgE mediated AD (r=0.670, P< 0.05) and children with non-IgE mediated AD. (r=0.605, P< 0.05) Serum TARC levels in control subjects decreased in accordance with age. (r=-0.201, P< 0.05) CONCLUSION: Serum TARC might be a useful marker for disease severity both in children with IgE mediated AD and children with non-IgE mediated AD. Serum TARC levels in control subjects decreased in accordance with ages.

Two Cases of Urticaria Developed by Antianemics which Contain Cow's Milk Protein (casein) or Egg White Protein (ovalbumin) / 소아알레르기및호흡기학회지

Hemo-Q (R) and Albumax (R) solution are widely used antianemics. Hemo-Q (R) contains cow's milk protein (casein) and Albumax (R) contains egg white protein (ovalbumin). Cow's milk protein and egg protein can cause common allergic diseases in infants and young children. We reported two cases of young children with milk and egg allergy who presented skin symptoms after ingestion or cutaneous contact with Hemo-Q (R) or Albumax (R) solution. When Hemo-Q (R) or Albumax (R) solution was taken or rubbed on, erythematous papules and wheals were developed in 10-20 minutes, but other antianemics which don't contain milk or egg protein contents didn't show skin manifestations.

The Relationship between Fungal Sensitization and Month of Birth in Children with Allergies / 소아알레르기및호흡기학회지

PURPOSE: Fungus allergy is one of the major causes of atopic diseases. It has been suggested that the exposure to aeroallergens during early infancy is important in subsequent development of sensitization, and the prevalence of allergic diseases. In this study, we analyzed the characteristics of molds through skin prick test results and tested whether the month of birth bears any relationship to the presence of fungal sensitization in children with allergies. METHODS: We performed skin prick test with 63 allergens in 3, 044 patients with allergies who visited Yonsei University Medical Center from March 1997 to December 2002. RESULTS: Three hundred seventy (12.2%) of 3, 044 patients showed positive skin prick test results due to fungal allergens. The most common positive allergenic reaction among fungal allergens was to Alternaria (7.8%). In 370 patients with positive skin prick test results caused by fungal allergens, 77% of the patients showed positive results to Dermatophagoides farinae, 76% to Dermatophagoides pteronyssinus, and 39% to house dust. Significant differences were observed in distribution of month of birth in subjects with fungal sensitization, with higher proportions being born in April and July. However, month of birth did not show a consistent seasonal preference in patients sensitized to mite or the non- sensitized group. CONCLUSION: Fungal sensitization is often associated with sensitization to other allergens. Month of birth seems to be related with sensitization to fungal allergens. Our results show that children born in April and July are at a higher risk of development of fungal sensitization in Korea.

Food Sensitization in Infants and Young Children with Atopic Dermatitis

Atopic dermatitis (AD) is a chronic, relapsing, inflammatory skin disease. Children with AD tend to have a higher prevalence of food allergies. This study investigated the clinical significance of food sensitization in AD patients. A total of 266 AD patients participated in this study. The prevalence of food sensitization and clinically relevant sensitization were compared in the subjects according to their age and AD severity. Sera from all patients were analyzed for food-specific IgE levels using the Pharmacia CAP System FEIA. The serum specific IgE levels for egg, milk, peanut and soybean were measured. Patients were regarded as sensitized to the food if their food-specific IgE levels were above 0.35 kUA/L. Also the food-specific IgE levels, the so-called diagnostic decision point, which is recommended as the clinically relevant level, for clinical food allergy, as suggested by Sampson et al, was used as an alternative method. From the measurement of food-specific IgE antibodies of the four foods, egg was the most highly sensitized and the main causative allergenic food in children with AD. The positive rates of specific IgE to the four major food allergens, and the prevalences of clinically relevant food sensitization, were higher for all foods tested in the group less than 1 year of age, and were significantly higher in moderate to severe AD compared to mild AD in infants and young children. In summary, presence of food specific IgE is prevalent in infants and young children with AD, and clinically relevant food sensitization is important in Korean infants and children with moderate to severe AD.