Associated Factors with Changes of Metabolic Abnormalities among General Population in COVID-19 Pandemic

Background@#The coronavirus disease-2019 (COVID-19) pandemic has led to restrictions on daily living including social distancing. These restrictions had an impact on the individual's healthy lifestyle and health status. We investigated the associated factors with changes of metabolic abnormalities among general population in COVID-19. @*Methods@#The participants were 43,639 people who received health check-ups twice in 2019 and 2021 during COVID-19 pandemic, at 16 health promotion centers. Metabolic abnormalities were identified according to the third report of the cholesterol education program criteria. Multiple logistic regression analysis was performed to confirm the factors related to changes of metabolic abnormalities during COVID-19. @*Results@#Metabolic syndrome and metabolic abnormalities increased overall during the COVID-19 pandemic. This increase was mostly appeared in males. The occurrence of metabolic syndrome during COVID-19 was associated with 50s and older age (odds ratio [OR], 1.130; 95% confidence interval [CI], 1.019-1.254), attempt to quit smoking (OR, 1.467; 95% CI, 1.171-1.839), start smoking (OR, 1.251; 95% CI, 1.110-1.412), decrease in aerobic exercise (OR, 1.328; 95% CI, 1.162-1.517), and increase in strength exercise (OR, 0.704; 95% CI, 0.592-0.838). @*Conclusions@#The metabolic syndrome is closely related to smoking experience and lack of exercise during COVID-19.

The patterns of lifestyle, metabolic status, and obesity among hypertensive Korean patients: a latent class analysis / 한국역학회지

OBJECTIVES@#This study aimed to identify latent classes in hypertensive patients based on the clustering of factors including lifestyle risk factors, metabolic risk factors, and obesity in each sex. @*METHODS@#This cross-sectional study included 102,780 male and 103,710 female hypertensive patients who underwent health check-ups at 16 centers in Korea, in 2018. A latent class analysis approach was used to identify subgroups of hypertensive patients. Multinomial logistic regression was performed to examine the association between latent classes and comorbidities of hypertension. @*RESULTS@#A four-class model provided the best fit for each sex. The following latent classes were identified: Class I (male: 16.9%, female: 1.7%; high risk of lifestyle behaviors [HB] with metabolic disorders and obesity [MO]), Class II (male: 32.4%, female: 47.1%; low risk of lifestyle behaviors [LB] with MO), Class III (male: 15.3%, female: 1.8%; HB with metabolic disorders and normal weight [MNW]), Class IV (male: 35.5%, female: 49.4%; LB with MNW). Lifestyle patterns in the latent classes were classified as high-risk or low-risk according to smoking and high-risk drinking among male, and presented complex patterns including physical inactivity alone or in combination with other factors, among female. Stage 2 hypertensive or diabetic individuals were likely to belong to classes including obesity (HB-MO, LB-MO) in both sexes, and additionally belonged to the HB-MNW class in male. @*CONCLUSIONS@#Metabolic disorders were included in all latent classes, with or without lifestyle risk factors and obesity. Hypertensive females need to manage obesity, and hypertensive males need to manage lifestyle risk factors and obesity. Sex-specific lifestyle behaviors are important for controlling hypertension.

The patterns of lifestyle, metabolic status, and obesity among hypertensive Korean patients: a latent class analysis / 한국역학회지

OBJECTIVES@#This study aimed to identify latent classes in hypertensive patients based on the clustering of factors including lifestyle risk factors, metabolic risk factors, and obesity in each sex. @*METHODS@#This cross-sectional study included 102,780 male and 103,710 female hypertensive patients who underwent health check-ups at 16 centers in Korea, in 2018. A latent class analysis approach was used to identify subgroups of hypertensive patients. Multinomial logistic regression was performed to examine the association between latent classes and comorbidities of hypertension. @*RESULTS@#A four-class model provided the best fit for each sex. The following latent classes were identified: Class I (male: 16.9%, female: 1.7%; high risk of lifestyle behaviors [HB] with metabolic disorders and obesity [MO]), Class II (male: 32.4%, female: 47.1%; low risk of lifestyle behaviors [LB] with MO), Class III (male: 15.3%, female: 1.8%; HB with metabolic disorders and normal weight [MNW]), Class IV (male: 35.5%, female: 49.4%; LB with MNW). Lifestyle patterns in the latent classes were classified as high-risk or low-risk according to smoking and high-risk drinking among male, and presented complex patterns including physical inactivity alone or in combination with other factors, among female. Stage 2 hypertensive or diabetic individuals were likely to belong to classes including obesity (HB-MO, LB-MO) in both sexes, and additionally belonged to the HB-MNW class in male. @*CONCLUSIONS@#Metabolic disorders were included in all latent classes, with or without lifestyle risk factors and obesity. Hypertensive females need to manage obesity, and hypertensive males need to manage lifestyle risk factors and obesity. Sex-specific lifestyle behaviors are important for controlling hypertension.

Relationship between Hypertension and Mircroalbuminuria according to Obesity Status in Prediabetes

BACKGROUND: Microalbuminuria (MA) is a predictor for diabetic nephropathy and mortality of cardiovascular disease. Diabetic nephropathy can be prevented by blood glucose and blood pressure control. Koreans have been found to have a significantly higher risk of type 2 diabetes than Caucasians, despite having normal weights. It is necessary to consider obesity status in the prevention of type 2 diabetes. This study aimed to determine the relationship between MA and hypertension according to obesity status in prediabetes.METHODS: This study was retrospectively conducted in 1,183 prediabetes, aged 30-70 years with fasting blood glucose levels of 100-125 mg/dL or hemoglobin A1c levels of 5.7–6.4% who health examinees at 16 health promotion centers from 2015 to 2016. Study subjects were classified according to obesity and hypertension. Obesity is defined as body mass index of ≥25 kg/m². Blood pressure was categorized as follows: normal blood pressure, <120/80 mmHg; prehypertension, 120–139/80–89 mmHg; and hypertension, ≥140/90 mmHg. We analyzed the relationship between MA and hypertension according to obesity using multivariable logistic regression analysis.RESULTS: While both prehypertensive and hypertensive subgroups were significantly associated with MA in the nonobese, the hypertensive subgroup was only associated with MA in the obese. In the combined effects of obesity and hypertension, prediabetes with normal weight and hypertension had the highest risk of MA (adjusted odds ratio, 6.39; 95% confidence interval, 2.90–14.10) compared to those with nonobese and normal blood pressure.CONCLUSIONS: Our findings suggest that nonobese prediabetes with hypertension would need to be more concerned about MA than do obese prediabetes with hypertension.

Experience and Current Use of Heated Tobacco Products in Korean Military Personnel

BACKGROUND: Heat tobacco products (HTPs) are emerging in Korea. There are few studies that investigated the rates of HTPs use among military personnel in Korea. This study was performed to identify the prevalence of HTPs experience and use. Also this study aimed to evaluate the related factors of HTPs experience and use among military personnel in Korea.METHODS: The study subjects were 3,878 military personnel participated health survey for Korean soldiers from November to December in 2018. Binominal logistic regression analysis was performed to confirm the related factors of HTPs experience and use among military personnel in Korea.RESULTS: The HTPs experience and current use rates of study subjects were 17.4% and 8.7%, respectively. And the HTPs experience and current use among military personnel was associated with college/university degree (adjusted odds ratio [aOR] 1.441, 1.377), lance-corporal (aOR 2.049, 5.636), superiors' smoking in military camp (aOR 1.516, 1.567), interest in health (aOR 1.637, 1.571), ever used smoking (aOR 2.817, 3.575), and ever used electronic cigarette (E-cigarette) (aOR 3.129, 1.587).CONCLUSIONS: The HTPs experience and current use among military personnel are closely related to educational level, military level, smoking status of the superiors, interests in health, conventional cigarette smoking, and E-cigarette use.

Relationship between Hypertension and Mircroalbuminuria according to Obesity Status in Prediabetes

BACKGROUND@#Microalbuminuria (MA) is a predictor for diabetic nephropathy and mortality of cardiovascular disease. Diabetic nephropathy can be prevented by blood glucose and blood pressure control. Koreans have been found to have a significantly higher risk of type 2 diabetes than Caucasians, despite having normal weights. It is necessary to consider obesity status in the prevention of type 2 diabetes. This study aimed to determine the relationship between MA and hypertension according to obesity status in prediabetes.@*METHODS@#This study was retrospectively conducted in 1,183 prediabetes, aged 30-70 years with fasting blood glucose levels of 100-125 mg/dL or hemoglobin A1c levels of 5.7–6.4% who health examinees at 16 health promotion centers from 2015 to 2016. Study subjects were classified according to obesity and hypertension. Obesity is defined as body mass index of ≥25 kg/m². Blood pressure was categorized as follows: normal blood pressure, <120/80 mmHg; prehypertension, 120–139/80–89 mmHg; and hypertension, ≥140/90 mmHg. We analyzed the relationship between MA and hypertension according to obesity using multivariable logistic regression analysis.@*RESULTS@#While both prehypertensive and hypertensive subgroups were significantly associated with MA in the nonobese, the hypertensive subgroup was only associated with MA in the obese. In the combined effects of obesity and hypertension, prediabetes with normal weight and hypertension had the highest risk of MA (adjusted odds ratio, 6.39; 95% confidence interval, 2.90–14.10) compared to those with nonobese and normal blood pressure.@*CONCLUSIONS@#Our findings suggest that nonobese prediabetes with hypertension would need to be more concerned about MA than do obese prediabetes with hypertension.

Experience and Current Use of Heated Tobacco Products in Korean Military Personnel

BACKGROUND@#Heat tobacco products (HTPs) are emerging in Korea. There are few studies that investigated the rates of HTPs use among military personnel in Korea. This study was performed to identify the prevalence of HTPs experience and use. Also this study aimed to evaluate the related factors of HTPs experience and use among military personnel in Korea.@*METHODS@#The study subjects were 3,878 military personnel participated health survey for Korean soldiers from November to December in 2018. Binominal logistic regression analysis was performed to confirm the related factors of HTPs experience and use among military personnel in Korea.@*RESULTS@#The HTPs experience and current use rates of study subjects were 17.4% and 8.7%, respectively. And the HTPs experience and current use among military personnel was associated with college/university degree (adjusted odds ratio [aOR] 1.441, 1.377), lance-corporal (aOR 2.049, 5.636), superiors' smoking in military camp (aOR 1.516, 1.567), interest in health (aOR 1.637, 1.571), ever used smoking (aOR 2.817, 3.575), and ever used electronic cigarette (E-cigarette) (aOR 3.129, 1.587).@*CONCLUSIONS@#The HTPs experience and current use among military personnel are closely related to educational level, military level, smoking status of the superiors, interests in health, conventional cigarette smoking, and E-cigarette use.

Entirely Replaced Left Gastric Artery from the Left Hepatic Artery: A Case Report

Arteries originating from the celiac axis have numerous anatomical variations. When performing interventional and surgical procedures, it is important to be aware of these variations to have better outcomes and to prevent iatrogenic complications. We report on a case of a 62-year-old man who came to our institution to receive transarterial chemoembolization for hepatocellular carcinoma. The computed tomography and angiography revealed a rare anatomic variation: the entire left gastric artery originated from the left hepatic artery with no other accessory feature of the left gastric artery from celiac axis or aorta was seen. To our knowledge, this is the first report on the entirely replaced left gastric artery from the left hepatic artery that was confirmed by utilizing both computed tomographic and angiographic images.

Complete Blood Count Reference Intervals and Patterns of Changes Across Pediatric, Adult, and Geriatric Ages in Korea

BACKGROUND: Sampling a healthy reference population to generate reference intervals (RIs) for complete blood count (CBC) parameters is not common for pediatric and geriatric ages. We established age- and sex-specific RIs for CBC parameters across pediatric, adult, and geriatric ages using secondary data, evaluating patterns of changes in CBC parameters. METHODS: The reference population comprised 804,623 health examinees (66,611 aged 3–17 years; 564,280 aged 18–59 years; 173,732 aged 60–99 years), and, we excluded 22,766 examinees after outlier testing. The CBC parameters (red blood cell [RBC], white blood cell [WBC], and platelet parameters) from 781,857 examinees were studied. We determined statistically significant partitions of age and sex, and calculated RIs according to the CLSI C28-A3 guidelines. RESULTS: RBC parameters increased with age until adulthood and decreased with age in males, but increased before puberty and then decreased with age in females. WBC and platelet counts were the highest in early childhood and decreased with age. Sex differences in each age group were noted: WBC count was higher in males than in females during adulthood, but platelet count was higher in females than in males from puberty onwards (P < 0.001). Neutrophil count was the lowest in early childhood and increased with age. Lymphocyte count decreased with age after peaking in early childhood. Eosinophil count was the highest in childhood and higher in males than in females. Monocyte count was higher in males than in females (P < 0.001). CONCLUSIONS: We provide comprehensive age- and sex-specific RIs for CBC parameters, which show dynamic changes with both age and sex.

Comparison of Traditional and Reverse Syphilis Screening Algorithms in Medical Health Checkups

BACKGROUND: The syphilis diagnostic algorithms applied in different countries vary significantly depending on the local syphilis epidemiology and other considerations, including the expected workload, the need for automation in the laboratory and budget factors. This study was performed to investigate the efficacy of traditional and reverse syphilis diagnostic algorithms during general health checkups. METHODS: In total, 1,000 blood specimens were obtained from 908 men and 92 women during their regular health checkups. Traditional screening and reverse screening were applied to the same specimens using automatic rapid plasma regain (RPR) and Treponema pallidum latex agglutination (TPLA) tests, respectively. Specimens that were reverse algorithm (TPLA) reactive, were subjected to a second treponemal test performed by using the chemiluminescent microparticle immunoassay (CMIA). RESULTS: Of the 1,000 specimens tested, 68 (6.8%) were reactive by reverse screening (TPLA) compared with 11 (1.1%) by traditional screening (RPR). The traditional algorithm failed to detect 48 specimens [TPLA(+)/RPR(−)/CMIA(+)]. The median TPLA cutoff index (COI) was higher in CMIA-reactive cases than in CMIA-nonreactive cases (90.5 vs 12.5 U). CONCLUSIONS: The reverse screening algorithm could detect the subjects with possible latent syphilis who were not detected by the traditional algorithm. Those individuals could be provided with opportunities for evaluating syphilis during their health checkups. The COI values of the initial TPLA test may be helpful in excluding false-positive TPLA test results in the reverse algorithm.

Human Papillomavirus Genotype Distribution Among 18,815 Women in 13 Korean Cities and Relationship With Cervical Cytology Findings

BACKGROUND: The prevalence and genotype distribution of Human papillomavirus (HPV) infection vary depending on geographical region and the immunity provided by vaccines. This study aimed to clarify the recent prevalence and genotype distribution of HPV according to age and cervical cytology findings in Korea. METHODS: This study included 18,815 health examinees that underwent cervical cytology and HPV genotyping tests at 16 centers of Korean Association of Health Promotion in 13 cities in Korea, between January 2014 and October 2015. HPV was genotyped by using multiplex PCR (Anyplex II HPV 28, Seegene, Korea), which detects 19 high-risk HPVs (HR-HPV) and nine low-risk HPVs (LR-HPV). RESULTS: Overall HPV prevalence was 27.8%, with 22.2% HR-HPV and 11.4% LR-HPV. The five most common carcinogens were HPV 52 (3.2%), 58 (2.7%), 16 (2.0%), 56 (1.9%), and 51 (1.8%). The five most common HR-HPVs in normal cytology samples were HPV 53, 68, 70, 52, and 58, while HPV 16, 52, 58, 33, and 31 were prevalent in high grade squamous intraepithelial lesions (HSIL). In atypical squamous cells of undetermined significance (ASCUS), the prevalence of HR-HPV varied with age; it was highest in those aged <30 yr, declining to a minimum at age 50–59 yr, and then increasing in older women (P<0.05). CONCLUSIONS: The prevalence and distribution of HR-HPV varied with age and cervical cytology findings. This information would be helpful in the development of cervical cancer prevention policies.

Comparison of Urine Albumin-to-Creatinine Ratio (ACR) Between ACR Strip Test and Quantitative Test in Prediabetes and Diabetes

BACKGROUND: Albuminuria is generally known as a sensitive marker of renal and cardiovascular dysfunction. It can be used to help predict the occurrence of nephropathy and cardiovascular disorders in diabetes. Individuals with prediabetes have a tendency to develop macrovascular and microvascular pathology, resulting in an increased risk of retinopathy, cardiovascular diseases, and chronic renal diseases. We evaluated the clinical value of a strip test for measuring the urinary albumin-to-creatinine ratio (ACR) in prediabetes and diabetes. METHODS: Spot urine samples were obtained from 226 prediabetic and 275 diabetic subjects during regular health checkups. Urinary ACR was measured by using strip and laboratory quantitative tests. RESULTS: The positive rates of albuminuria measured by using the ACR strip test were 15.5% (microalbuminuria, 14.6%; macroalbuminuria, 0.9%) and 30.5% (microalbuminuria, 25.1%; macroalbuminuria, 5.5%) in prediabetes and diabetes, respectively. In the prediabetic population, the sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of the ACR strip method were 92.0%, 94.0%, 65.7%, 99.0%, and 93.8%, respectively; the corresponding values in the diabetic population were 80.0%, 91.6%, 81.0%, 91.1%, and 88.0%, respectively. The median [interquartile range] ACR values in the strip tests for measurement ranges of 300 mg/g were 9.4 [6.3-15.4], 46.9 [26.5-87.7], and 368.8 [296.2-575.2] mg/g, respectively, using the laboratory method. CONCLUSIONS: The ACR strip test showed high sensitivity, specificity, and negative predictive value, suggesting that the test can be used to screen for albuminuria in cases of prediabetes and diabetes.

Factors Affecting Radiation Exposure during Lumbar Epidural Steroid Injection: A Prospective Study in 759 Patients

OBJECTIVE: To estimate and compare radiation exposure and intervention time during lumbar epidural steroid injection (ESI) 1) under different practitioners and methods with continuous fluoroscopic monitoring, and 2) under one practitioner with different methods and monitoring. MATERIALS AND METHODS: We consecutively recruited 804 patients who underwent lumbar ESI and 759 patients who underwent 922 interventions were included for analysis in this investigation. Three different practitioners (a senior faculty member, junior faculty member, trainee) performed lumbar ESI using different methods (caudal, interlaminar, transforaminal). The senior faculty member performed lumbar ESI under two different methods of fluoroscopic monitoring (continuous [CM] and intermittent monitoring [IM]). The dose area product (DAP) fluoroscopy time, and intervention time during lumbar ESI were compared for 1) ESI methods and practitioners under CM, and 2) ESI methods and monitoring. RESULTS: With CM, interaction between the effects of the practitioner and the intervention on DAP was significant (p < 0.001), but not fluoroscopy time (p = 0.672) or intervention time (p = 0.852). The significant main effects included the practitioner and intervention on DAP, fluoroscopy time, and intervention time with CM (p < 0.001). DAPs and fluoroscopy time for caudal, interlaminar, and transforaminal ESI were higher with CM than with IM (p < 0.001). Intervention time did not differ between CM and IM. CONCLUSION: Radiation exposure is dependent on the practitioners and methods and within the established safety limits during lumbar ESIs under CM. With an experienced practitioner, IM leads to less radiation exposure than CM.

Factors related to the Management of MultiDrug-Resistant Organisms among Intensive Care Unit Nurses: An Application of the Health Belief Model / 기본간호학회지

PURPOSE: The purpose of this study was to identify factors which influence the management of MultiDrug-Resistant Organisms (MDROs) by nurses in Intensive Care Units (ICUs). METHODS: Data were collected from December 8 to 20, 2013 and participants were 163 ICU nurses working in one general hospital. The Health Belief Model tool and knowledge and management of MDROs infection tools were used in the study. Descriptive statistics, t-test, analysis of variances, Pearson correlation coefficients and multiple regression were used to analyze the data. RESULTS: Knowledge, perceived susceptibility, and perceived benefits had a significant influence on MRSA (Methicillin Resistant Staphylococcus Aureus,) and MDRAB (Multidrug Resistant Acinetobacter Baumannii) infection management when all the other variables were considered. Significant variable which had influence on VRE (Vancomycin Resistant Eenterococci) infection management were perceived susceptibility and perceived benefits. CONCLUSION: Perceived susceptibility and perceived benefits had significant influence on MDROs infection management. Emphasis needs to be on the perceived susceptibility and perceived benefits of MDROs infection management when providing an educational program for ICU nurses.

Vitamin D Levels and Prevalence of Vitamin D Deficiency Associated with Sex, Age, Region, and Season in Koreans

BACKGROUND: Although many studies on vitamin D have been conducted, they have not been consistent regarding the method of measurement, the individuals investigated, and the season of blood sampling. Thus, this study was performed to investigate 25-hydroxy vitamin D [25(OH)D] levels and the prevalence of 25(OH)D deficiency by age, region, and season using the standard method for vitamin D measurement. METHODS: A total of 17,252 health examinees (9,180 men and 8,072 women) who were administered the vitamin D test at 16 health promotion centers in 13 cities in Korea from January to December 2013 were selected for this study. Measurements of 25(OH)D2 and 25(OH)D3 were performed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) using the MSMS Vitamin D Kit. RESULTS: The levels of 25(OH)D were significantly lower among women than men. The median 25(OH)D value was lowest among men and women in their 20s when compared to other age groups. We observed the lowest levels in January and February and the highest levels in August, September, and October. The prevalence of 25(OH)D deficiency (having levels of <10 ng/mL) was significantly higher among women than men. When different age groups were analyzed, the highest rates of 25(OH)D deficiency were found in their 20s, and prevalence decreased with age (up to an age of 60 years). Lastly, the prevalence of 25(OH)D deficiency was highest in Seoul and the Gyeonggi area when compared to other regions. CONCLUSIONS: Level of 25(OH)D and the prevalence of 25(OH)D deficiency differed by sex, age, month (season), and region.

Vitamin D Levels and Prevalence of Vitamin D Deficiency Associated with Sex, Age, Region, and Season in Koreans

BACKGROUND: Although many studies on vitamin D have been conducted, they have not been consistent regarding the method of measurement, the individuals investigated, and the season of blood sampling. Thus, this study was performed to investigate 25-hydroxy vitamin D [25(OH)D] levels and the prevalence of 25(OH)D deficiency by age, region, and season using the standard method for vitamin D measurement. METHODS: A total of 17,252 health examinees (9,180 men and 8,072 women) who were administered the vitamin D test at 16 health promotion centers in 13 cities in Korea from January to December 2013 were selected for this study. Measurements of 25(OH)D2 and 25(OH)D3 were performed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) using the MSMS Vitamin D Kit. RESULTS: The levels of 25(OH)D were significantly lower among women than men. The median 25(OH)D value was lowest among men and women in their 20s when compared to other age groups. We observed the lowest levels in January and February and the highest levels in August, September, and October. The prevalence of 25(OH)D deficiency (having levels of <10 ng/mL) was significantly higher among women than men. When different age groups were analyzed, the highest rates of 25(OH)D deficiency were found in their 20s, and prevalence decreased with age (up to an age of 60 years). Lastly, the prevalence of 25(OH)D deficiency was highest in Seoul and the Gyeonggi area when compared to other regions. CONCLUSIONS: Level of 25(OH)D and the prevalence of 25(OH)D deficiency differed by sex, age, month (season), and region.

Acute Myeloid Leukemia with Persistent Marrow Aplasia after Chemotherapy Treated with Reduced-Intensity Allogeneic Stem Cell Transplantation / 대한내과학회지

Persistent bone marrow aplasia after intensive chemotherapy is uncommon, but is one of the fatal complications in patients with acute myeloid leukemia (AML). Although allogeneic hematopoietic stem cell transplantation (HSCT) is considered to be contraindicated for patients who have hematologic diseases with serious infections, such as bacterial septicemia or invasive fungal diseases, combined with prolonged neutropenia due to frequent morbidity and mortality, such risks can be overcome by non-myeloablative conditioning and best supportive care. Here, we report an AML patient with persistent marrow aplasia after induction therapy, treated successfully with reduced-intensity allogeneic HSCT despite severe bacterial and fungal infections.

Erratum: A Case of Acute Pyogenic Sacroiliitis and Bacteremia Caused by Community-Acquired Methicillin-Resistant Staphylococcus aureus / 감염과화학요법

We found an error in our published article. Figure 2 should be corrected.

Nocardia Brain Abscess in an Immunocompetent Patient / 감염과화학요법

Nocardia cerebral abscess is rare, constituting approximately 1-2% of all cerebral abscesses. Mortality for a cerebral abscess of Nocardia is three times higher than that of other bacterial cerebral abscesses, therefore, early diagnosis and therapy is important. Nocardia cerebral abscess is generally occur among immunocompromised patients, and critical infection in immunocompetent patients is extremely rare. We report on a case of a brain abscess by Nocardia farcinica in an immunocompetent patient who received treatment with surgery and antibiotics. This is the second case of a brain abscess caused by N. farcinica in an immunocompetent patient in Korea.

A Case of Acute Pyogenic Sacroiliitis and Bacteremia Caused by Community-Acquired Methicillin-Resistant Staphylococcus aureus / 감염과화학요법

Pyogenic sacroiliitis is a rare osteoarticular infection, occurring most frequently in children and young adults. Diagnosis of the disease is challenging because of a general lack of awareness of the disease and its nonspecific signs and symptoms. Staphylococcus aureus is the most common causative bacteria in pyogenic sacroiliitis. Methicillin-resistant S. aureus (MRSA) has typically been considered a hospital-associated pathogen; however, community-acquired (CA)-MRSA infections are becoming increasingly common in Korea. We report the first domestic case of acute pyogenic sacroiliitis with abscess and bacteremia caused by CA-MRSA. The pathogen carried the type IV-A staphylococcal cassette chromosome mec (SCCmec) without the Panton-Valentine leukocidin (PVL) gene, and was identified as sequence type (ST) 72 by multilocus sequence typing.