Successfully treated infective endocarditis caused by methicillin-resistant Staphylococcus Aureus in extremely low birth weight infant / 소아과

Survival rates of preterm infants have improved in the past few decades, and central venous catheters play an important role in the intensive medical treatment of these neonates. Unfortunately, these indwelling catheters increase the risk of intracardiac thrombosis, and they provide a nidus for microorganisms during the course of septicemia. Herein, we report a case of persistent bacteremia due to methicillin-resistant Staphylococcus aureus in an extremely low birth weight (ELBW) infant, along with vegetation observed on an echocardiogram, the findings which are compatible with a diagnosis of endocarditis. The endocarditis was successfully treated with antibiotic therapy, and the patient recovered without major complications. We suggest a surveillance echocardiogram for ELBW infants within a few days of birth, with regular follow-up studies when clinical signs of sepsis are observed.

Usefulness of Electroencephalography after Partial Sleep Deprivation for the Diagnosis of Epilepsy in Children / 대한소아신경학회지

PURPOSE: The benefit of electroencephalography after sleep deprivation (SDEEG) in the diagnosis of epilepsy is controversial, and it is difficult to apply SDEEG to all pediatric patients in the clinical setting. This study is to figure out the usefulness of SDEEG for the detection of epileptiform discharges (EDs). METHODS: Medical records were reviewed retrospectively. Routine electroencephalography (REEG) was performed in 150 patients, and SDEEG was taken in 69 patients among the study population(n=219). The detection rates of EDs were compared between two groups, and also compared according to the presence of sleep in each group. RESULTS: The detection rate of EDs was higher in SDEEG group than in REEG group [n=69 (59.4%) vs n=150 (43.3%), P=0.03). Whereas there was no significant differences of the detection rate of EDs between REEG with and without sleep recording groups (43.8% vs 38.5%, P=0.777), there was significantly higher detection rate of EDs in SDEEG with sleep than SDEEG without sleep recording groups [n=63 (61.9%) vs n=6 (33.3%), P=0.022]. The detection rate of EDs was not significantly different between each group with and without sleep recording in overall EEGs (49.5% vs 36.8%, P=0.342). However, in overall EEGs with sleep recording, the detection rate of EDs was statistically significantly higher in SDEEG group than REEG group [n=63 (61.9%) vs n=137 (43.8%), P=0.022]. CONCLUSION: SDEEG revealed higher detection rate of EDs than REEG. It is not because of the effect of sleep recording, but of sleep deprivation itself. SDEEG is useful tool to apply for the diagnosis of epilepsy in daily clinical practice in children.