Clinical Effects of Oseltamivir in Children with Influenza in Busan, in the First Half of 2004 / 소아과

PURPOSE: Although influenza is one of the most important causes of acute respiratory tract infections in children, effective antiviral therapies are not common and there are only a few clinical studies on treatment of influenza in children. We evaluated the efficacy of oseltamivir in the treatment of naturally aquired influenza in children during the first half of 2004 in Busan. METHODS: From January 2004 to June 2004, throat swabs and nasal washes were performed and cultured for the isolation of influenza virus and tested by rapid antigen detection test (QuickVue influenza test) in children with suspected influenza infections. The children who responded positively to the QuickVue influenza test, we divided into two groups: an oseltamivir treatment group and a control group. We compared their clinical symptoms (including fever duration) and diagnosis. The medical records of patients with influenza virus infection were reviewed retrospectively. RESULTS: A total of 621 individuals were suspected of influenza infection. Influenza viruses were isolated in 79 (17.2 percent) out of 621 patients examined. QuickVue influenza tests were positive in 181 cases. The treatment group (83 individuals) received oseltamivir twice daily for 5 days, and the control group (99 individuals) were administered only symptom relief medicine. There was no differences between the two groups in clinical diagnosis and symptoms. Oseltamivir treatment reduced the fever duration and other respiratory symptoms. There were no adverse events associated with oseltamivir treatment. CONCLUSION: Our data suggest that oral oseltamivir treatment reduces the fever duration and other respiratory symptoms of acute influenza without side effects in children.

Spontaneous Ileal Perforation in Very Low Birth Weight Infant without Evidence of Necrotizing Enterocolitis

Ongoing advances in the treatment of very-low-birth-weight infants have confronted us with a growing number of infants susceptible to acquired illnesses of the gastrointestinal tract. Although necrotizing enterocolitis has been regarded as the major cause of gastrointestinal perforation in preterm infants, the incidence of spontaneous perforation occurred in an apparently normal bowel is increasing. The risk factors for spontaneous intestinal perforation include prematurity, twin pregnancies, perinatal asphyxia, prior use of umbilical artery catheter, use of indomethacin and/or steroid, and bacterial or fungal sepsis. We report a case of spontaneous ileal perforation occurred in very low birth weight infant who was successfully treated with emergency operation.

Successful Long Term Antifungal Agent Therapy for Renal Candidiasis without Surgical Drainage in a Very Low Birth Weight Infant

Improved survival rate of premature infants requiring intensive care lead into an increased risk for nosocomial infections such as disseminated fungal infection. Neonatal candida sepsis has become one of the most important causes of neonatal morbidity and mortality. The most common site of end organ involvement in premature infants with candidemia is the kidney. But no consensus has been reached concerning the treatment of candidemia in the newborn. We recently experienced a case of premature infant who was diagnosed as renal candidiasis with microabscess formation due to Candida Albicans and patient was treated successfully with long term liposomal amphotericin B and fluconazole therapy without surgical drainage.

Comparison of the Effectiveness of Phototherapy for Nonhemolytic Hyperbilirubinemia in Breast-fed and Formula-fed Infants

PURPOSE: This study was designed to evaluate the efficacy of phototherapy for nonhemolytic hyperbilirubinemia in breast-fed and formula-fed infants and infants receiving formula and breast milk. METHODS: Full-term healthy infants with nonhemolytic hyperbilirubinemia (bilirubin concentration > or =13.0 mg/dL) were treated with conventional phototherapy by using daylight fluorescent lamps. Three groups of infants were studied : group A, formula-fed infants; group B, breast-fed infants; group C, infants receiving formula and breast milk. All patterns of feeding started at birth. Phototherapy was terminated only when bilirubin concentration had decreased to less than 10.0 mg/dL. RESULTS: A total of 163 infants were studied. Phototherapy was highly effective in reducing the bilirubin concentration in all three groups, however, its efficacy of in group B was poorer compared with the other two groups. The duration of photopherapy and weight loss during phototherapy were not significantly different in the three groups. Decrease rates of bilirubin concentration during phototherapy in group A and C were significantly faster than that of group B. CONCLUSION: The response to phototherapy of group B infants was significantly slower than those of group A and C infants. The addition of formula to the feedings for totally breast-fed infants, without suspension of breast feeding, would enhance the efficacy of phototherapy and reduce exposure time.