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Background@#Staphylococcus lugdunensis is an emerging pathogen in skin and soft tissue infections. However, until recently, the role of S. lugdunensis as a skin pathogen remained underrated. @*Objective@#The purpose of this study was to investigate the clinical characteristics and antibiotic susceptibility of S.lugdunensis isolated from skin diseases. @*Methods@#This is a retrospective chart review of 48 cases in which S. lugdunensis was isolated from bacterial skin cultures between 2016 and 2021. @*Results@#Among the 48 patients, the mean age was 41.0 years, 54.2% were male, and 12.5% of the patients had immunosuppressive diseases. Nearly 87.4% of infections occurred below the waist and the dominant sources of isolation were epidermal cyst (31.3%) and hidradenitis suppurativa (29.2%). The rate of resistance of S. lugdunensis against β-lactam antibiotics were as follows: penicillin, 83.3%; oxacillin, 37.5%; and methicillin, 29.2%. @*Conclusion@# S. lugdunensis is emerging as one of the primary pathogens of skin infections. When S. lugdunensis is isolated, dermatologists should consider that it is not just a component of the skin flora but can also be a pathogen. If S. lugdunensis is identified as the cause of infection, it should be managed with appropriate antibiotic therapy.
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Pembrolizumab is an immune checkpoint inhibitor that selectively blocks the programmed cell death (PD)-1 receptor. Although it has a dramatic effect on the treatment of advanced malignancies, instability of immune tolerance may cause immune-related adverse events in the skin. A 62-year-old male with a history of metastatic urothelial carcinoma was referred to the dermatology department and presented with a widespread mucocutaneous rash. Itching appeared 7 days after the first administration of pembrolizumab, and on the third day after the second administration, an erythematous maculopapular rash that coalesced into large flaccid bullae on the whole body with a positive Nikolsky’s sign developed. A biopsy revealed a subepidermal bulla with basal keratinocyte necrosis. Pembrolizumab was discontinued due to the diagnosis of toxic epidermal necrolysis (TEN), and intravenous methylprednisolone was started. Herein, we report a case of TEN induced by pembrolizumab to highlight immune-related cutaneous adverse events in patients receiving anti-PD-1 therapy.
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Background@#A rifampicin (RF)-clindamycin (CL) combination therapy is recommended as the first-line treatment for moderate to severe hidradenitis suppurativa (HS). Although the long-term use of RF requires caution due to the possibility of developing resistant bacteria, only a few studies have investigated alternatives for this combination therapy. @*Objective@#To evaluate the efficacy of systemic CL mono-therapy and assess the prevalence and CL resistance of bacterial growth in HS patients. @*Methods@#A total of 53 HS patients treated with CL mono-therapy were included. The efficacy was evaluated by identifying the rate of HS Clinical Response (Hi-SCR) achievers and comparing HS Physician’s Global Assessment (HS-PGA) before (W0) and after (W8) the treatment. Purulent material from HS skin lesions was collected on the W0. Bacterial flora and antibiotic sensitivity were determined by bacterial cultures. @*Results@#Of 53 HS patients, 34 were eligible for evaluation of the efficacy of the therapy. Twenty-one patients (61.76%) achieved Hi-SCR. The mean scoring of HS-PGA had significantly decreased from 3.24 to 2.15 (p=0.001). The prevalence of CL resistance was 15.00%. No significant differences in the efficacy of the therapy according to the presence of CL-resistant bacteria on the W0 were observed (p=0.906). Adverse events occurred in 26.42% of patients. @*Conclusion@#Systemic CL mono-therapy may be a safe and useful alternative to RF-CL combination therapy, and no significant difference in the efficacy of the therapy depending on the presence of CL-resistant bacteria was observed.
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Sarcoidosis is a chronic multi-organ disorder of unknown etiology, characterized by the development of non-caseating granulomas. Scar sarcoidosis is a cutaneous manifestation of sarcoidosis that originates in old cutaneous scars. Sarcoidosis may develop in scars that occur after surgery, vaccination, cosmetic tattoos, and herpes zoster infection. Upper eyelid blepharoplasty is the most popular aesthetic facial surgery performed in the Asian population. Despite the large number of blepharoplasty procedures performed over the last century, relatively few reports have described scar sarcoidosis involving a blepharoplasty scar. We report a rare case of sarcoidosis that originated in a post-blepharoplasty scar, together with a literature review. Scar sarcoidosis should be considered in the differential diagnosis in patients who present with post-blepharoplasty changes in an old scar.
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Background@#Psoriasis is a chronic T17 cell-driven immune-mediated inflammatory disease. However, patients with psoriasis may have elevated total serum immunoglobulin E (IgE) levels, which is a hallmark of Th2 inflammation.In previous case reports, psoriasis patients with elevated total serum IgE levels did not respond well to treatment or had exacerbated eczema lesions. @*Objective@#We sought to investigate the clinical characteristics of psoriasis patients with elevated total serum IgE levels. @*Methods@#This is a retrospective chart review of 130 patients with psoriasis who were tested for total serum IgE levels from November 1, 2009, to October 31, 2019. We compared the demographics, clinical characteristics, disease severity, and treatment regimen for each elevated IgE group (＞214 U/mL) and normal IgE group (≤214 U/mL). @*Results@#Among 130 patients with psoriasis, 41 (31.5%) had elevated total serum IgE levels. Elevated total serum IgE levels were positively associated with the severity of disease; psoriasis lesions including those on the scalp, hands, feet, and flexures, which are difficult to treat, were observed to be significantly higher in patients with elevated total serum IgE levels. There was no correlation between age, sex, disease duration, or presence of pruritus and total serum IgE levels. @*Conclusion@#This study identified the clinical characteristics of psoriasis patients with elevated total serum IgE levels in Korea.
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Background@#Patients with stable psoriasis showing clearear-clear response can consider extending the dosing interval of biologics. However, few studies have reported the treatment outcomes following irregular dosing intervals of biologics in patients with psoriasis. @*Objective@#We compared treatment outcomes after regular and irregular dosing intervals of biologics in patients with psoriasis. @*Methods@#This single-center, retrospective observational study included patients who received biologics for treatment of plaque psoriasis between January 1, 2014 and December 31, 2019. We compared patient demographics, clinical characteristics, biologics administered, and treatment outcomes based on the regularity of the dosing interval. @*Results@#Among 95 patients investigated, 63 (66.3%) received biologics at regular dosing intervals. We observed no significant intergroup differences in the final Psoriasis Area Severity Index (PASI) scores (1.2 vs. 1.8, p=0.16) and in the percentage improvement in PASI scores from baseline levels (−89.8% vs. −90.8%, p=0.68). The rate at which biologics were switched was higher in the irregular-dosing group than in the regular-dosing group; however, the difference was statistically nonsignificant (28.1% vs. 12.7%, p=0.06). We observed a significant intergroup difference in patients who were administered guselkumab at baseline (12 [21.8%] vs. 0 [0.0%], p=0.01). @*Conclusion@#This study showed that compared with regular dosing intervals, irregular dosing intervals of biologics were associated with high rates of switching of these agents, although we observed no statistically significant differences with regard to PASI scores. Therefore, it is important to adhere to the standard dosing schedule prescribed for biologics, and guselkumab may improve patient compliance.
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Background@#Vulvar pruritus is a common complaint among women presenting to dermatologists. However, few studies have analyzed the dermatologic conditions that cause it. @*Objective@#This retrospective study aims to evaluate the clinical features and causes of pruritic skin lesions of the female external genitalia. @*Methods@#This study included 161 female patients with vulvar pruritus between 2008 and 2018 at CHA Bundang Medical Center. Data were collected by reviewing the electronic medical records retrospectively. The age, diagnosis, and histopathologic findings of the patients were reviewed. @*Results@#The patients’ mean age was 49 years. On physical examination, 71.4% of patients (n=115) had definite skin lesions, and 28.6% (n=46) had ‘vulvar pruritus without skin rash’. The most common diagnostic category, confirmed by skin biopsy, was inflammatory dermatoses (53.4%, n=86), including lichen sclerosus et atrophicus, lichen simplex chronicus, nonatopic eczema, atopic eczema, and psoriasis. Moreover, 7.5% of patients (n=12) were diagnosed with infectious diseases, including candidiasis, herpes simplex virus, syphilis, and scabies; 5.6% (n=9) were diagnosed with neoplastic diseases, including vulvar intraepithelial neoplasia, squamous cell carcinoma, extramammary Paget’s disease, and Bowen’s disease. @*Conclusion@#The causes of vulvar itch are vast, and often, multiple causes coexist simultaneously. Therefore, it requires a systemic approach to establish the correct diagnosis. Dermatologists should actively participate in the diagnosis and treatment.
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Background@#Patients with stable psoriasis showing clearear-clear response can consider extending the dosing interval of biologics. However, few studies have reported the treatment outcomes following irregular dosing intervals of biologics in patients with psoriasis. @*Objective@#We compared treatment outcomes after regular and irregular dosing intervals of biologics in patients with psoriasis. @*Methods@#This single-center, retrospective observational study included patients who received biologics for treatment of plaque psoriasis between January 1, 2014 and December 31, 2019. We compared patient demographics, clinical characteristics, biologics administered, and treatment outcomes based on the regularity of the dosing interval. @*Results@#Among 95 patients investigated, 63 (66.3%) received biologics at regular dosing intervals. We observed no significant intergroup differences in the final Psoriasis Area Severity Index (PASI) scores (1.2 vs. 1.8, p=0.16) and in the percentage improvement in PASI scores from baseline levels (−89.8% vs. −90.8%, p=0.68). The rate at which biologics were switched was higher in the irregular-dosing group than in the regular-dosing group; however, the difference was statistically nonsignificant (28.1% vs. 12.7%, p=0.06). We observed a significant intergroup difference in patients who were administered guselkumab at baseline (12 [21.8%] vs. 0 [0.0%], p=0.01). @*Conclusion@#This study showed that compared with regular dosing intervals, irregular dosing intervals of biologics were associated with high rates of switching of these agents, although we observed no statistically significant differences with regard to PASI scores. Therefore, it is important to adhere to the standard dosing schedule prescribed for biologics, and guselkumab may improve patient compliance.
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Background@#Vulvar pruritus is a common complaint among women presenting to dermatologists. However, few studies have analyzed the dermatologic conditions that cause it. @*Objective@#This retrospective study aims to evaluate the clinical features and causes of pruritic skin lesions of the female external genitalia. @*Methods@#This study included 161 female patients with vulvar pruritus between 2008 and 2018 at CHA Bundang Medical Center. Data were collected by reviewing the electronic medical records retrospectively. The age, diagnosis, and histopathologic findings of the patients were reviewed. @*Results@#The patients’ mean age was 49 years. On physical examination, 71.4% of patients (n=115) had definite skin lesions, and 28.6% (n=46) had ‘vulvar pruritus without skin rash’. The most common diagnostic category, confirmed by skin biopsy, was inflammatory dermatoses (53.4%, n=86), including lichen sclerosus et atrophicus, lichen simplex chronicus, nonatopic eczema, atopic eczema, and psoriasis. Moreover, 7.5% of patients (n=12) were diagnosed with infectious diseases, including candidiasis, herpes simplex virus, syphilis, and scabies; 5.6% (n=9) were diagnosed with neoplastic diseases, including vulvar intraepithelial neoplasia, squamous cell carcinoma, extramammary Paget’s disease, and Bowen’s disease. @*Conclusion@#The causes of vulvar itch are vast, and often, multiple causes coexist simultaneously. Therefore, it requires a systemic approach to establish the correct diagnosis. Dermatologists should actively participate in the diagnosis and treatment.
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Purpose@#The sonographic differential diagnosis of umbilical polyps and granulomas in children based on correlations with pathologic findings. @*Methods@#We retrospectively analyzed the ultrasonographic findings of twenty-two umbilical masses in children that were pathologically confirmed as umbilical polyps or umbilical granulomas by surgery. We analyzed size, depth, echogenicity, internal content, intralesional vascularity, and the presence of unobliterated medial umbilical ligament. Pathologic correlation was performed for all of the umbilical masses. @*Results@#Twenty-two masses consisted of eight umbilical polyps and fourteen umbilical granulomas. The mean age of the children with umbilical polyps was 30.13 months (range, 2 to 108 months) and it was 1.33 months (range, 0.6 to 3 months) for the children with umbilical granulomas. The average mass sizes were 10.25 mm (range, 5 to 35 mm) for umbilical polyps and 6.21 mm (range, 3 to 10 mm) for umbilical granulomas. The umbilical polyps were manifested as cystic lesions with thick echogenic walls in five patients (62.5%), which were associated with the intestinal mucosa (four lesions) and ectopic pancreatic tissue (one lesion) on pathology. Umbilical granulomas were superficially located in 13 (92.9%) and solid in thirteen (92.9%), which correlated with prominent granulation tissues on pathology. Seven (87.5%) of the eight umbilical granulomas were hypervascular and correlated with neovascularization on pathologic examination. @*Conclusion@#The umbilical polyps revealed deep-seated, hypovascular nodules with cyst formation surrounded by thick echogenic walls. In contrast, the umbilical granulomas revealed superficially located hypervascular hypoechoic solid nodules in young infants.
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PURPOSE@#This study aimed to compare the image quality and adverse events between Iopamidol 250 and Ioversol 320 usage during transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).@*MATERIALS AND METHODS@#Medical records and hepatic angiography from 113 patients who underwent TACE with Iopamidol 250 (44 patients) and Ioversol 320 (69 patients) were retrospectively reviewed. Vessel perception on hepatic angiography was graded into three categories by two radiologists for hepatic subsegmental arteries, the right gastroepiploic artery, right gastric artery, and pancreaticoduodenal artery. Imaging concordance was assessed by comparing the number of detected HCCs on hepatic angiography and CT. The adverse events before and after hepatic angiography were evaluated.@*RESULTS@#The mean vessel perception scores were 2.92 and 2.94 for Iopamidol 250 and Ioversol 320, respectively. The imaging concordance was 31 (70.5%) and 46 (66.7%) patients for Iopamidol 250 and Ioversol 320, respectively. There were no statistical differences in vessel perception or imaging concordance (p > 0.05). One and six patients experienced nausea for Iopamidol 250 and Ioversol 320, respectively. There was no statistical difference in adverse events (p = 0.24).@*CONCLUSION@#Iopamidol 250 can be used in hepatic angiography for TACE without significant difference in image quality or occurrence of adverse events from Ioversol 320.
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Adenoid cystic carcinoma (ACC) is a malignant glandular neoplasm that commonly occurs in the salivary glands. Primary cutaneous adenoid cystic carcinoma (PCACC) is a rare form of ACC that primarily presents on the skin. A diagnosis of a primary tumor arising in the skin can be made only after excluding metastatic deposits from other, more common sites. PCACC tends to infiltrate and recur locally but rarely metastasizes to distant organs and lymph nodes. To our knowledge, this is the first reported case of a PCACC of the chest wall in Korea. We report this case and literature review to raise awareness of this rare tumor.
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Sarcoidosis is a multisystem granulomatous disease of unknown etiology. A range of factors including tuberculous infection, beryllium exposure, and cold climate have been implicated in the pathogenesis of the condition. A 45-year-old woman presented with a 4-month history of an asymptomatic eyelid swelling and multiple erythematous papules on the neck. Histological examination of the neck, orbital soft tissue, and lacrimal gland was consistent with sarcoidosis. Ziehl−Neelsen stains and polymerase chain reactions (PCRs) for tuberculosis on the skin biopsy specimens were negative. However, the orbital soft tissue specimen was positive for non-tuberculous mycobacteria (NTM) PCR. The patient was finally diagnosed with sarcoidosis associated with NTM. Treatment with systemic steroid and hydroxychloroquine was started, resulting in an improvement of skin lesions. We herein report a case of sarcoidosis associated with NTM infection with review of the literature, as only little is known regarding the role of mycobacteria in sarcoidosis.
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Background@#s: The severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) has spread worldwide. Cardiac injury after SARS-CoV-2 infection is a major concern. The present study investigated impact of the biomarkers indicating cardiac injury in coronavirus disease 2019 (COVID-19) on patients' outcomes. @*Methods@#This study enrolled patients who were confirmed to have COVID-19 and admitted at a tertiary university referral hospital between February 19, 2020 and March 15, 2020. Cardiac injury was defined as an abnormality in one of the following result markers: 1) myocardial damage marker (creatine kinase-MB or troponin-I), 2) heart failure marker (N-terminal-pro B-type natriuretic peptide), and 3) electrical abnormality marker (electrocardiography). The relationship between each cardiac injury marker and mortality was evaluated. Survival analysis of mortality according to the scoring by numbers of cardiac injury markers was also performed. @*Results@#A total of 38 patients with COVID-19 were enrolled. Twenty-two patients (57.9%) had at least one of cardiac injury markers. The patients with cardiac injuries were older (69.6 ± 14.9 vs. 58.6 ± 13.9 years old, P = 0.026), and were more male (59.1% vs. 18.8%, P = 0.013).They showed lower initial oxygen saturation (92.8 vs. 97.1%, P = 0.002) and a trend toward higher mortality (27.3 vs. 6.3%, P = 0.099). The increased number of cardiac injury markers was significantly related to a higher incidence of in-hospital mortality which was also evidenced by Kaplan-Meier survival analysis (P = 0.008). @*Conclusion@#The increased number of cardiac injury markers is related to in-hospital mortality in patients with COVID-19.
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Background@#Rosacea is a common skin disease associated with increased expression of cathelicidin, kallikrein 5 (KLK5), toll-like receptor (TLR) 2, and abnormal barrier function. Recently, it was reported that hyaluronan (HA) could influence immune function via various receptors and HA oligosaccharides (oligo-HAs) could suppress TLR-dependent cytokine expression. @*Objective@#We investigated if oligo-HAs could influence on inflammation and epidermal barrier induced by LL-37, which had a major role in rosacea. @*Methods@#We cultured normal human keratinocytes and treated them with LL-37 and oligo-HAs or the LL-37 alone. A rosacea-like BALB/c mouse model injected with LL-37 was used to determine the role of oligo-HAs in rosacea in vivo. @*Results@#Interleukin-8 (IL-8) and tumor necrosis factor (TNF)-α release was suppressed when keratinocytes were co-treated with oligo- HAs and LL-37 compared with keratinocytes treated with LL-37 only. Treatment with oligo-HAs resulted in decreased transepidermal water loss as well as improved redness. Decreased inflammatory cell infiltration, IL-17A and KLK5 expression and increased CD44 and filaggrin expression were also noted. @*Conclusion@#Our findings suggest that oligo-HA improves rosacea-like phenotype through anti-inflammatory and epidermal barrier improving effect.
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Subject(s)
Humans , Bowen's Disease , Follow-Up Studies , Observational Study , Photochemotherapy , Recurrence , Retrospective Studies , Treatment OutcomeABSTRACT
BACKGROUND: The incidence of cutaneous malignant tumors and premalignant lesions has recently increased worldwide. However, studies investigating the incidence and clinical manifestations of cutaneous malignant tumors and premalignant lesions in Korea are rare, especially in southeastern Gyeonggi-do Province. OBJECTIVE: To analyze the recent trends in the incidence of cutaneous malignant tumors and premalignant lesions in southeastern Gyeonggi-do Province. METHODS: We retrospectively reviewed 451 cases of cutaneous malignant tumors and 455 cases of premalignant lesions from 2006 to 2016. RESULTS: The average annual incidence rates of cutaneous malignant tumors and premalignant lesions among the total number of outpatients was 0.84% and 0.85%, respectively, and both these rates increased significantly over time. Basal cell carcinoma was most commonly diagnosed cutaneous malignant tumor (50.8%), followed by squamous cell carcinoma (24.6%), malignant melanoma (8.2%), and metastatic carcinoma (5.1%). The most common premalignant lesion was actinic keratosis (60.0%). The mean age of the patients with cutaneous malignant tumors and premalignant lesions was 68.8 years and 70.8 years, respectively. The ratio of male to female patients was 1 : 1.19 for cutaneous malignant tumors and 1 : 2.01 for premalignant lesions. The face was the most common site for both cutaneous malignant tumors and premalignant lesions (at 71.9% and 75.8%, respectively). CONCLUSION: This retrospective study provided data about the incidence and clinical patterns of cutaneous malignant tumors and premalignant lesions among patients in southeastern Gyeonggi-do Province.
Subject(s)
Female , Humans , Male , Carcinoma, Basal Cell , Carcinoma, Squamous Cell , Incidence , Keratosis, Actinic , Korea , Melanoma , Outpatients , Retrospective Studies , Statistics as TopicABSTRACT
OBJECTIVES: Pathogenic Vibrio species are widely distributed in warm estuarine and coastal environments, and can infect humans through the consumption of raw or mishandled contaminated seafood and seawater. For this reason, the distribution of these bacteria in South Korea was investigated.METHODS: Seawater samples were collected from 145 coastal area points in the aquatic environment in which Vibrio species live. Environmental data (i.e., water temperature, salinity, turbidity, and atmospheric temperature) was collected which may help predict the distribution of the species (data not shown). Seawater samples were filtered, and incubated overnight in alkaline peptone water, at 37°C. Using species-specific polymerase chain reaction methods, screening tests were performed for the hlyA, ctxA, vvhA, and tlh genes. Clones of pathogenic Vibrio species were isolated using 3 selective plating media.RESULTS: In 2017, total seawater isolation rates for Vibrio vulnificus, Vibrio cholerae (non-pathogenic, non-O1, non-O139 serogroups), and Vibrio parahaemolyticus were 15.82%, 13.18%, 65.80%, respectively. However, in 2018 isolation rates for each were 21.81%, 19.40%, and 70.05%, respectively.CONCLUSION: The isolation rates of pathogenic Vibrio species positively correlated with the temperature of seawater and atmosphere, but negatively correlated with salinity and turbidity. From 2017 to 2018, the most frequent seawater-isolated Vibrio species were V. parahaemolyticus (68.10 %), V. vulnificus (16.54%), and non-toxigenic V. cholerae (19.58%). Comprehensive monitoring, prevention, and control efforts are needed to protect the public from pathogenic Vibrio species.
Subject(s)
Humans , Atmosphere , Bacteria , Cholera , Clone Cells , Korea , Mass Screening , Peptones , Polymerase Chain Reaction , Salinity , Seafood , Seawater , Vibrio cholerae , Vibrio parahaemolyticus , Vibrio vulnificus , Vibrio , WaterABSTRACT
In the present study, the productions of antinociception induced by acute and chronic immobilization stress were compared in several animal pain models. In the acute immobilization stress model (up to 1 hr immobilization), the antinociception was produced in writhing, tail-flick, and formalin-induced pain models. In chronic immobilization stress experiment, the mouse was enforced into immobilization for 1 hr/day for 3, 7, or 14 days, then analgesic tests were performed. The antinociceptive effect was gradually reduced after 3, 7 and 14 days of immobilization stress. To delineate the molecular mechanism involved in the antinociceptive tolerance development in the chronic stress model, the expressions of some signal molecules in dorsal root ganglia (DRG), spinal cord, hippocampus, and the hypothalamus were observed in acute and chronic immobilization models. The COX-2 in DRG, p-JNK, p-AMPKα1, and p-mTOR in the spinal cord, p-P38 in the hippocampus, and p-AMPKα1 in the hypothalamus were elevated in acute immobilization stress, but were reduced gradually after 3, 7 and 14 days of immobilization stress. Our results suggest that the chronic immobilization stress causes development of tolerance to the antinociception induced by acute immobilization stress. In addition, the COX-2 in DRG, p-JNK, p-AMPKα1, and p-mTOR in the spinal cord, p-P38 in the hippocampus, and p-AMPKα1 in the hypothalamus may play important roles in the regulation of antinociception induced by acute immobilization stress and the tolerance development induced by chronic immobilization stress.
Subject(s)
Animals , Mice , Diagnosis-Related Groups , Ganglia, Spinal , Hippocampus , Hypothalamus , Immobilization , Spinal CordABSTRACT
PURPOSE: The aim of the study was to identify factors related to the recurrence of intussusception in pediatric patients. METHODS: The medical charts of patients diagnosed with intussusception and treated at Dongsan Medical Center, between March 2015 to June 2017, were retrospectively reviewed. Univariate and multivariate analyses were performed. RESULTS: Among 137 patients, 23 patients (16.8%) had a recurrent intussusception and 8 of these patients (6%) had more than 2 episodes of recurrence. The age at diagnosis was significantly different between the non-recurrence and recurrence group (p=0.026), with age >1 year at the time of diagnosis associated with a greater rate of recurrence (p=0.002). The time interval from symptom onset to the initial reduction ( 1 year at the time of presentation (odds ratio [OR], 4.79; 95% confidence interval [CI], 1.56–14.06; p=0.016) and no history of infection (OR, 0.18; 95% CI, 0.06–0.58; p=0.004) were retained as predictors of recurrence. CONCLUSION: Patients with intussusception who are older than 1 year at diagnosis, have an elevated CRP level, a delay of ≥48 hours between symptom onset and the initial reduction, an absence of bloody stools, and no history of infection should be closely monitoring for symptoms and signs of a possible recurrence.