• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.16 no.4
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• pp.219-224
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• 2013

Acute abdominal pain is a common complaint in childhood, and it can be caused by a wide range of underlying surgical and non-surgical conditions. The most common non-surgical condition is gastroenteritis, while the most common surgical condition is appendicitis. Abdominal pain in children varies with age, associated symptoms, and pain location. Although acute abdominal pain is usually benign and self-limiting, there are uncommon but life-threatening conditions that require urgent care. Meticulous history taking and physical examinations are essential to determine the cause of acute abdominal pain and to identify children with surgical conditions such as appendicitis.

• Journal of Life Science
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• v.21 no.6
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• pp.845-850
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• 2011

Norovirus (NoV) causes major acute non-bacterial gastroenteritis in humans. NoV genus is a member of the family Caliciviridae, which is transmitted by contaminated food and water or from human to human. Many genotypes of genogroups I and II have been reported because of their high genetic diversity. To obtain molecular epidemiological information on gastroenteritis sporadic cases in Busan, Korea, we analyzed the nucleotide sequences of NoV strains detected during 2008~2010. We performed one step RT-PCR amplifying the open reading frame (ORF) 2 (capsid region) followed by semi-nested PCR. Fecal samples were collected from 4,071 acute gastroenteritis, and genotypes of the 421 positive samples were determined by sequence analysis. Based on partial sequence of capsid region, 7 NoV were categorized into genogroup I and 13 into genogroup II. Prevalent genotypes among gastroenteritis patients within Busan were GII.4, GI.6, GII.5 in 2008~2010. The results of this study will contribute to the currently available epidemiological data and improve public health and hygiene via development of diagnostic methods and sustainable surveillance.

• Korean Journal of Microbiology
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• v.48 no.2
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• pp.102-108
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• 2012

Fecal specimens from acute gastroenteritis in Seoul from 2003 to 2007 were collected and then tested for the presence of Norovirus by RT-PCR. Among a total of 4,685 samples investigated, 383 samples (8.2%) were positive. The analysis of outbreaks related norovirus contamination occurred from 2003 to 2007 in Seoul revealed 57 cases happened during investigated period. Seasonal prevalence showed winter season predominant characteristics of pattern of epidemics by long term investigation for norovirus infections. The incidence of norovirus infection in the case of acute gastroenteritis by catering food in school were 32%, by food in general restaurant were 29%. This epidemiological investigation in Seoul was strongly needed for control and prevention of outbreaks related with norovirus by forecasting disease epidemics.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.17 no.3
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• pp.140-146
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• 2014

Purpose: The etiology of acute gastroenteritis (AGE) has changed since the introduction of the rotavirus vaccination. The aim of this study was to clarify which common pathogens, both bacterial and viral, are currently causing AGE in infants. Methods: Infants with acute diarrhea were enrolled. We tested for 10 bacterial pathogens and five viral pathogens in stool specimens collected from infants with AGE. The clinical symptoms such as vomiting, mucoid or bloody diarrhea, dehydration, irritability, and poor oral intake were recorded, and laboratory data such as white blood cell count and C-reactive protein were collected. The clinical and laboratory data for the cases with bacterial pathogens and the cases with viral pathogens were compared. Results: Of 41 total infants, 21 (51.2%) were positive for at least one pathogen. Seventeen cases (41.5%) were positive for bacterial pathogens and seven cases (17.1%) were positive for viral pathogens. Staphylococcus aureus (13 cases, 31.7%) and Clostridium perfringens (four cases, 9.8%) were common bacterial pathogens. Norovirus (five cases, 12.2%) was the most common viral pathogen. Fever and respiratory symptoms were common in the isolated viral infection group (p=0.023 and 0.044, respectively), whereas other clinical and laboratory data were indistinguishable between the groups. Conclusion: In our study, S. aureus (41.5%) and norovirus (12.2%) were the most common bacterial and viral pathogens, respectively, among infants with AGE.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.5
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• pp.431-440
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• 2019

Purpose: No national survey has yet described the guidelines followed by Korean pediatricians to treat acute gastroenteritis (AGE). An online survey was performed to investigate the management of AGE followed by members of The Korean Society of Pediatric Gastroenterology, Hepatology, and Nutrition, and the results were compared between pediatric gastroenterologists (PG) and general pediatricians (GP). Methods: Questionnaires were sent to pediatricians between June 2 and 4, 2018 regarding the type of hospital, indications for admission, antiemetic and antidiarrheal drugs and antibiotics prescribed, and dietary changes advised. Results: Among the 400 pediatricians approached, 141 pediatricians (35.3%) responded to the survey. PG comprised 39% of the respondents and 72.7% worked at a tertiary hospital. Both PG and GP considered diarrhea or vomiting to be the primary symptom. The most common indication for hospitalization was severe dehydration (98.8%). Most pediatricians managed dehydration with intravenous fluid infusions (PG 98.2%, GP 92.9%). Antiemetics were prescribed by 87.3% of PG and 96.6% of GP. Probiotics to manage diarrhea were prescribed by 89.1% of PG and 100.0% of GP. Antibiotics were used in children with blood in diarrheal stool or high fever. Dietary changes were more commonly recommended by GP (59.3%) than by PG (27.3%) (p<0.05). Tests to identify etiological agents were performed primarily in hospitalized children. Conclusion: This survey assessing the management of pediatric AGE showed that the indications for admission and rehydration were similar between GP and PG. Drug prescriptions for diarrhea and dietary changes were slightly commonly recommended by GP than by PG.

• Kosin Medical Journal
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• v.33 no.2
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• pp.150-158
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• 2018

Objectives: Although Campylobacter is the main cause for bacterial acute gastroenteritis (AGE), there has been no notable clinical research into it, especially for Korean children. In this study, we share our experience of clinical, laboratory and image findings with Campylobacter AGE. Methods: Between May 2013 and June 2016, children diagnosed as having Campylobacter AGE were retrospectively enrolled in our study. Campylobacter AGE was considered diagnosed when a patient had symptoms of bacterial AGE and a positive Campylobacter result in stool using multiplex PCR. Results: Among 539 patients with suspected bacterial AGE, 31 (5.8%) patients had a positive result for Campylobacter. The average age of the 31 patients was $10.2{\pm}5.0$ years with a range between 1.1 and 16.9 years. Eighteen (58%) of the total patients were hospitalized between June and August. Diarrhea (93.5%), abdominal pain (83%) and fever (83%) were common symptoms. For 20 patients (65%), diarrhea lasted for less than three days, and fever lasted for 2.1 days on average. Among the 20 patients subjected to imaging studies, 12 patients (60%) showed bowel wall thickening on the right side of colon. In blood tests of 30 patients, 22 (73%) and 29 (97%) patients exhibited leukocytosis and elevated C-reactive protein, respectively. During treatment for Campylobacter AGE, prediagnostic empirical antibiotics were used for 6 (19%) patients. All patients recovered without complications. Conclusions: Among the children with suspected bacterial AGE, 5.8% had a positive result on Campylobacter in stool using multiplex PCR. Therefore, we observe that Campylobacter AGE should be considered in school-age children who have diarrhea, fever, and abdominal pain.

• Clinical and Experimental Pediatrics
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• v.52 no.4
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• pp.453-457
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• 2009

Purpose : Our aim was to describe the clinical features of noroviral gastroenteritis in children. Methods : This study included 22 children with noroviral gastroenteritis, as confirmed by stool RT-PCR, who were admitted to Bundang CHA Hospital between July 2006 and June 2008. Their medical records were reviewed and compared with those of 45 children with rotaviral gastroenteritis. Results : In the norovirus group, 19 (86.4%) children showed vomiting and 21 (95.5%) children showed diarrhea, while all children in the rotaviral group showed both vomiting and diarrhea. The duration of vomiting was not different in the two groups, but mean episodes of vomiting/24 h were higher in the norovirus group than in the rotavirus group. The duration of diarrhea was longer and mean episodes of diarrhea/24 h were higher in the rotavirus group. The Vesikari Scale was not different in the two groups. Frequency and duration of fever did not show a significant difference. Most children in both groups were below 2 years of age. Conclusion : Clinical features of noroviral gastroenteritis were largely similar to those of rotaviral gastroenteritis, but vomiting was more severe in noroviral infection, and diarrhea was more severe and prolonged in rotaviral infection. With regard to noroviral infection, further epidemiologic investigations and preventive efforts are essential.

• Microbiology and Biotechnology Letters
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• v.47 no.2
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• pp.289-295
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• 2019

Acute diarrhea is a global health problem that causes high morbidity and mortality in children. Notably, enteric pathogen co-infections have been suggested to play an important role in gastroenteritis. In this study, we analyzed 1150 stool specimens of patients who visited the pediatric ward of Dongguk University Hospital in Gyeongju province from January 2011 to December 2017. The average isolation rate of potential stool pathogens over 7 years was 37.3% (429/1150), and coinfections were observed in 51 patients (51/429; 11.9%). In the 51 co-infection cases, the most frequent type of co-infection was found to be that of virus-bacteria (33/51). The most frequently detected bacterial pathogen among the co-infected cases was Clostridium spp. (22/51), out of which Clostridium perfringens was found to be the main pathogen (16/22; 72.7%). Escherichia coli spp. were the second most common bacterial pathogens found in 12 cases (12/51; 23.5%), with 10 cases of E. coli EPEC. Furthermore, the most frequently implicated viral pathogen among the co-infected cases was norovirus (16/51), followed by rotavirus (12/51).

• The Journal of the Korean Society for Microbiology
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• v.17 no.1
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• pp.15-19
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• 1982

Fifty two infants and young children hospitalized in the pediatric department of Hanyang University Hospital with acute gastroenteritis from February through April 1982 were examined for the evidence of infection with rotavirus by electron microscopic technique and enzyme-linked immunosorbent assay(ELISA). Of 52 patients examined, rotaviruses were detected in stools of 11 patients(21%) by EM technique and 16 patients(31%) by ELISA. But there was no significant statistical difference between the two methods(Z=1.2<2). During the study period, rotaviruses were detected in stools of 6(38%) of 16 patients in February, 10(30%) of 33 patients in March, and none of 3 patients in April. The age of the 16 patients who shed the rotaviruses in their stools ranged from 3 months to 6 years, and 12 patients(75%) were between 6 and 24 months. Our study suggests that the rotaviral gastroenteritis of infants and young children in Korea might have similar frequency, seasonal variation, and age distribution with other countries in temperate zone.

• Childhood Kidney Diseases
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• v.13 no.2
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• pp.235-241
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• 2009

Purpose : The purpose of this study was to determine the clinical value of bicarbonate gap (BG) in acute gastroenteritis by comparison of clinical manifestations and laboratory findings. Methods : We retrospectively analyzed 135 patients who had acute gastroenteritis. We classified them into two groups: $BG{\leq}-5$ (group A), BG>-5 (group B). We made a comparative study for clinical manifestations, serum electrolyte, albumin, protein, blood urea nitrogen (BUN), creatinine, anion gap (AG), delta anion gap (${\Delta}AG$) and delta bicarbonate (${\Delta}HCO_3{^-}$) between the two groups. Results : The duration of hospitalization and diarrhea was significantly longer in group A than group B. In laboratory findings, serum sodium, serum total $CO_2$, total protein, $AG_{corrected}$ and ${\Delta}AG$ were lower in group A than group B. ${\Delta}HCO_3{^-}$ and chloride were higher in group A than group B. Conclusion : BG may be a sensitive predictor enough to access the severity of acute gastroenteritis.