ABSTRACT
PURPOSE: Although annual epidemics occur, there are only a few clinical studies on influenza in Korea. We evaluated the epidemic and clinical features of acute lower respiratory tract infections in children by influenza virus. METHODS: From Feb., 1995 to July, 1997, influenza virus isolations and clinical review were performed on hospitalized children with acute lower respiratory tract infections at Hangang Sacred Heart Hospital. RESULTS: The influenza virus was isolated in 34 out of 545 (6.2%) patients examined. The number of influenza A and B viruses isolated were as follows : 0 and 2 from Feb. to March, 1995, 8 and 1 from Nov., 1995 to May, 1996, and 15 and 9 from Dec., 1996 to June, 1997. The patients were 27 boys and 7 girls with a mean age of 27.6 +/- 25.1 months. Eight patients (23.5%) had preceding underlying diseases such as asthma, bronchopulmonary dysplasia and ventricular septal defect (VSD) with Down syndrome. Three out of twenty-two patients surveyed had been vaccinated against influenza virus before infection. The acute lower respiratory tract infections diagnosed were pneumonia in 11, bronchiolitis in 9, croup in 8, and tracheobronchitis in 6 patients. Fever, cough, and rhinorrhea developed in all patients and fever continued for a mean 5.5 +/- 4.0 days. All patients recovered without antiviral treatment except one expired case with penumonia/VSD/Down syndrome. CONCLUSION: Acute lower respiratory tract infections caused by influenza virus developed every winter and spring during the period of the study. Influenza vaccination before epidemic season should be encouraged in risky patients.
Subject(s)
Child , Female , Humans , Infant, Newborn , Asthma , Bronchiolitis , Bronchopulmonary Dysplasia , Child, Hospitalized , Cough , Croup , Down Syndrome , Fever , Heart , Heart Septal Defects, Ventricular , Herpesvirus 1, Cercopithecine , Influenza, Human , Korea , Orthomyxoviridae , Pneumonia , Respiratory System , Respiratory Tract Infections , Seasons , VaccinationABSTRACT
BACKGROUND: Nsocomial candidemia has increased during the last decade. We studied the clinical features, underlying illnesses, risk factors, and outcome of nosocomial candidemia patients. METHODS: We reviewed 137 admitted patients with nosocomial candidemia at Hangang Sacred Heart Hospital from Jan., 1990 to Dec., 1996. RESULTS: The annual occurrence of nosocomial candidemia from 1990 to 1996 was 2, 0, 4, 15, 45, 49, and 22, respectively. There were 99 males and 38 females, with a mean age of 37.9+/-15.6 years. Burn was the most common underlying illness(80.3%). Identified Candida species were C. albicans(68.0%), C. parapsilosis(25.0%), C. tropicalis, C. guilliermondii, and C. glabrata. The risk factors of candidemia were ICU care, broad-spectrum antibiotic therapy, central venous catheter insertion, and parenteral hyperalimentation. Concomitant focal candidal infections occurred in 71 patients and concomitant bacterial infections developed in 41 patients. Main clinical features were fever, leukocytosis, and tachypnea. Chorioretinitis developed in 6 patients by C. albicans and C. parapsilosis in five and one case, respectively. Overall mortality rate was 35.8% with lower mortality in cases with burn, antifungal treatment, and removal of central venous catheter. CONCLUSION: When fever persists despite the use of broad-spectrum antibiotics in burn patients or otherwise immunocompromised hosts, empirical antifungal treatment along with removal of central venous catheter and an ophthalmologic examination should be considered.