Predictors of Meningitis in Febrile Infants Aged 3 Months or Younger / 소아감염

PURPOSE:The purpose of this study was to identify useful predictors for diagnosing bacterial meningitis and performing CSF studies in febrile infants three months or younger. METHODS:Six hundred and fifty two febrile infants with a rectal temperature > or =38.0 degreesC presented from January 2003 to April 2008 and were retrospectively studied. The total white blood cell count (WBC), band count, absolute neutrophil count (ANC), quantitative C-reactive protein (CRP) and blood cultures were performed on admission. The clinical variables associated with bacterial meningitis were analyzed. RESULTS:In patients with bacterial meningitis, the clinical variables including CRP (P= 0.036), band count (P=0.037), ANC (P=0.036) and age (P=0.001) were significantly different. The area under the receiver-operating characteristic curve was 0.969 for CRP, 0.946 for the band count, 0.765 for the ANC and 0.235 for age. A CRP cutoff point of 8 mg/dL was determined to maximize both the sensitivity and specificity (sensitivity 83%, specificity 95%, likelihood ratio 16.6). A CRP concentration of or =9 mg/dL increased the clinical suspicion of bacterial meningitis and the need for CSF evaluation.

Isolated Splenic Vein Thrombosis Associated with Acute Pancreatitis / 대한소아소화기영양학회지

Pancreatic disease is the most frequent cause of isolated splenic vein thrombosis. Splenic vein thrombosis causes a localized form of portal hypertension known as sinistral or left-sided portal hypertension. Splenic vein thrombosis may be complicated by the formation of gastric varices, with the potential of massive upper gastrointestinal bleeding. Whereas splenectomy is considered to be the treatment of choice for symptomatic splenic vein thrombosis, the role of splenectomy in the patient with asymptomatic splenic vein thrombosis remains controversial. We report a rare case of acute pancreatitis complicated by isolated asymptomatic splenic vein thrombosis. Recognition of this disease entity is important because the risk of secondary variceal bleeding, while uncommon, can be life-threatening.