Clinical Manifestations, Management, and Natural Course of Infants with Recurrent Bronchiolitis or Reactive Airways Disease / 소아감염

PURPOSE: The purpose of this study was to investigate the clinical manifestations and 5-year natural course of recurrent bronchiolitis or reactive airways disease (RAD) in infants. METHODS: We reviewed the medical records of infants with recurrent bronchiolitis from January 2007 to December 2007 at The Catholic University of Korea St. Mary's Hospital in Incheon, South Korea. Additionally, we telephoned their parents to confirm their present medical statuses. RESULTS: Sixty-three subjects with recurrent bronchiolitis were identified. The mean age at admission was 8.1 months and the number of males was 44 (69.8%). Of the 63 infants with recurrent bronchiolitis, inhaled corticosteroids, bronchodilators, and antibiotics were given to 62 (98.4%), 53 (84.1%), and 40 (63.5%), respectively. Among the total 63 subjects, we were able to contact the parents of 45 children by telephone. None of these children had been hospitalized during the previous one year period due to respiratory infections or for other medical reasons. Of the 45 subjects we were able to contact, 38 (84.4%) had not experienced any further respiratory difficulties at all. Five (11.1%) had been diagnosed with allergic rhinitis while two (4.4%) were being managed for asthma. CONCLUSION: Most children who presented with recurrent episodes of bronchiolitis in infancy did not show any further respiratory difficulties after five years of age.

Macrophage Activation Syndrome as the Extreme Form of Kawasaki Disease / 소아감염

Few cases of macrophage activation syndrome (MAS) or reactive hemophagocytic lymphohistiocytosis (HLH) during the acute febrile phase of Kawasaki disease (KD) have been reported. We report on a case of a 19 month-old girl with MAS or reactive HLH during the course of KD. Despite immunoglobulin and steroid therapy, she showed persistent fever with hepatosplenomegaly and evidence of hemophagocytosis in the bone marrow. A high index of suspicion for clinical features associated with MAS is necessary for KD patients in order to provide appropriate treatment.