• Clinical and Experimental Pediatrics
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• 제48권3호
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• pp.235-250
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• 2005

Acute diarrhea is one of the most common diseases that are seen in pediatric patients. In the management of acute diarrhea, several differential diagnostic criteria should be considered based on clinical and/or laboratory findings. These criteria include : (1) normal variant stool versus diarrhea (2) infectious versus non-infectious condition and (3) bacterial versus non-bacterial etiology. The use of antibiotics should be considered to manage diarrhea caused by bacteria accompanying fever and bloody diarrhea in the following cases : (1) patients with serious clinical course, (2) under three months, (3) immunocompromised patients, (4) patients with nutritional deficiency and (5) patients presenting with moderate-to-severe dehydration. In patients presenting with the symptoms suspected to be bacterial origin, whose clinical course is not serious, antibiotic therapy is not necessary. These patients are easily manageable at OPD level. Moreover, except for some cases in which the use of antibiotics is inevitable, pediatric diarrhea can be managed by providing the suitable foods alone with no necessity of other specific drugs. Accordingly, it is crucial not so much to depend on the drugs as to provide appropriate foods including oral rehydration solution(ORS) with no further episodes of diarrhea. Special attention should be paid to the fact that younger pediatric patients will undergo nutritional deficiency unless acute diarrhea is properly managed.

• Clinical and Experimental Pediatrics
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• 제55권3호
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• pp.77-82
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• 2012

Human astrovirus (HAstV) is a major cause of acute diarrhea among children, resulting in outbreaks of diarrhea and occasionally hospitalization. Improved surveillance and application of sensitive molecular diagnostics have further defined the impact of HAstV infections in children. These studies have shown that HAstV infections are clinically milder (diarrhea, vomiting, fever) than infections with other enteric agents. Among the 8 serotypes of HAstV identified, serotype 1 is the predominant strain worldwide. In addition to serotype 1, the detection rate of HAstV types 2 to 8 has increased by using newly developed assays. HAstV is less common compared with other major gastroenteritis viruses, including norovirus and rotavirus; however, it is a potentially important viral etiological agent with a significant role in acute gastroenteritis. A better understanding of the molecular epidemiology and characteristics of HAstV strains may be valuable to develop specific prevention strategies.

• 대한응급의학회지
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• 제26권1호
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• pp.29-37
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• 2015

Purpose: Stool exams are a useful tool for the early presumptive diagnosis of infectious bacterial diarrhea in the Emergency Department (ED). CT scans are often used to increase the physician's level of certainty and to facilitate patient triage by identifying the source of pain in most patients with an acute abdomen in the ED. This study was designed to investigate the correlation between stool exams and abdominal CT in patients with acute diarrhea visiting the ED. Methods: We conducted a retrospective study in the emergency department of a national university hospital from January 1, 2012 to June 30, 2013. The subjects consisted of 156 patients with acute diarrhea and abdominal pain who had stool exam results and abdominal CT findings. We divided the patients into three groups according to the stool exam results. Simultaneously, we evaluated their CT findings of the bowel and adjacent structures. Results: A total of 156 patients were enrolled. Frequency of abnormal CT findings showed statistically significant correlation with stool exams (p-value <0.001). Abnormal CT findings increased as WBCs and RBCs in stool increased (p-value <0.001). Conclusion: The stool exam was a statistically significant predictive variable in indirectly determining the severity of acute diarrhea and it showed correlation with the frequency of abnormal CT findings. It is suggested that stool exams can be used as a susceptible marker for predicting the probability of severe infectious colitis, and for making an early decision regarding close medical attention.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권4호
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• pp.369-376
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• 2019

Purpose: The aim of this study was to evaluate the clinical significance of inflammatory biomarkers in acute infectious diarrhea among children. Methods: Clinical parameters including fever, bacterial and viral etiology based on stool culture and multiplex polymerase chain reaction, and nine biomarkers including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and leukocytes in blood and calprotectin, lactoferrin, myeloperoxidase, polymorphonuclear elastase, leukocytes, and occult blood in feces were evaluated in children who were hospitalized due to acute diarrhea without underlying disease. Results: A total of 62 patients were included. Among these patients, 33 had fever, 18 showed bacterial infections, and 40 patients were infected with 43 viruses. Of all the biomarkers, CRP was significantly correlated with fever (p<0.001). CRP, ESR, calprotectin, lactoferrin, myeloperoxidase, fecal leukocytes, and occult blood were significantly associated with infection with bacterial pathogens (p<0.001, p=0.04, p=0.03, p=0.003, p=0.02, p=0.03, p=0.002, respectively). The combination of CRP and fecal lactoferrin at their best cut-off values (13.7 mg/L and $22.8{\mu}g/mL$, respectively) yielded a sensitivity of 72.2%, and a specificity of 95.5% for bacterial etiology compared with their individual use. Conclusion: Blood CRP is a useful diagnostic marker for both fever and bacterial etiology in acute pediatric diarrhea. The combination of CRP and fecal lactoferrin yields better diagnostic capability for bacterial etiology than their use alone for acute diarrhea in children without underlying gastrointestinal disease.

• Parasites, Hosts and Diseases
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• 제61권1호
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• pp.15-23
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• 2023

Concerns about foodborne illnesses caused by Kudoa septempunctata are steadily growing, but reports of K. septempunctata in clinical and food specimens related to food poisoning in Korea are limited. This study aimed to genetically identify K. septempunctata in patients with acute diarrhea and in clinical and food samples related to food poisoning caused by sashimi consumption. Both real-time and nested polymerase chain reaction assays were performed to detect K. septempunctata 18S and 28S rDNA genes in the stools of 348 patients with acute diarrhea, 11 samples (6 stool and 5 rectal swab samples) from patients with food poisoning, and 2 raw Paralichthys olivaceus samples collected from a restaurant where a food poisoning incident occurred. K. septempunctata was identified in 5 clinical specimens (4 stools and 1 rectal swab) and 1 P. olivaceus sashimi sample. All detected K. septempunctata were of genotype ST3. This is the first study to identify K. septempunctata in both patients and food samples with epidemiological relevance in Korea, providing evidence that it is a pathogen that causes food poisoning. Also, this is the first study to confirm the presence of K. septempunctata genes in rectal swabs. Despite continuing suspected occurrences of Kudoa foodborne outbreaks, the rate of identification of K. septempunctata is very low. One reason for this is the limitation in obtaining stool and vomit samples for the diagnosis of Kudoa infection. We strongly suggest the inclusion of rectal swabs among the diagnostic specimens for Kudoa food poisoning.

• Pediatric Infection and Vaccine
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• 제6권2호
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• pp.203-209
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• 1999

목 적 : 급성 설사는 아동기의 가장 흔한 질환 중 하나이다. 감염성 설사는 세균보다는 바이러스에 의한 빈도가 높으며 대부분 적절한 수분 공급 및 대증 요법에 의하여 저절로 호전되는 양상을 보인다. 항생제의 사용에 대한 많은 논의가 이루어지고 있고 실제 임상에서 사용되는 예들이 많으나 그 효과는 확실치 않다. 이에 저자는 소아의 급성 설사에 항생제가 어떠한 영향을 미치는지 알아보고자 본 연구를 시행하였다. 방 법 : 1996년 8월부터 1997년 7월까지 급성 설사를 주소로 대전 을지대학병원에 입원하였던 124명을 대상으로 항생제를 사용하지 않은 군 28명 (N군)과 항생제를 사용한 군 96명 (P군)으로 나누어 입원과 발열기간, 구토와 설사의 빈도를 후향적으로 비교 분석하였다. 결 과 : 입원기간은 P군보다 N군에서 유의 있게 짧았다(P<0.05). 발열과 설사의 기간 역시 N군에서 더 짧았다(P<0.05). 구토와 설사의 빈도는 N군이 P군보다 낮았으나 통계적인 유의성은 없었다. 연령, 성비, 입원 전 설사기간과 입원 당시의 CRP는 두 군간에 통계적 차이가 없었다. 결 론 : 소아의 급성설사는 원인균에 관계없이 자연 소실될 수 있는 질환으로서 대부분 적절한 수액공급과 영양공급으로 호전될 수 있고 항생제의 사용은 오히려 설사를 악화시킬 수 있으며 동반되는 구토 및 발열기간을 지연시킬 수 있다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권5호
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• pp.464-471
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• 2020

Purpose: Some probiotic strains reduce the duration of acute diarrhea. Because of strain and product specificity, each product needs to be supported by clinical data. This study aimed to test the efficacy of the synbiotic food supplement Probiotical (Streptococcus thermophilus, Lactobacillus rhamnosus, Lactobacillus acidophilus, Bifidobacterium lactis, Bifidobacterium infantis, fructo-oligosaccharides) in children with acute gastroenteritis of likely infectious origin. The primary endpoint was the number of children with normal stool consistency during the treatment duration. Methods: A total of 46 children (aged 3.6 months to 12 years) with acute gastroenteritis that started less than 48 hours prior to their visit at a hospital-based emergency department were included in this prospective, randomized, placebo-controlled trial. All children were treated with oral rehydration solution and placebo (n=20) or the test product (n=26). Results: Significantly more children had a normal stool consistency on days 1 and 2 in the probiotic group: 5 children (20%) on day 1 in the probiotic group compared with none in the placebo group (p=0.046). On day 2, 11 children in the probiotic group (46%) and 3 (16%) in the placebo group (p=0.024) had a normal stool consistency. The mean duration of diarrhea was shorter in the probiotic group compared with that in the placebo group (3.04±1.36 vs. 4.20±1.34 days) (p=0.018). Conclusion: The test product was shown to normalize stool consistency significantly more rapidly than the placebo. These data confirm the findings from a previous study in a larger group of children performed in a primary healthcare setting.

• Clinical and Experimental Pediatrics
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• 제48권7호
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• pp.691-695
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• 2005

There is scientific evidence that administration of probiotics is effective in the treatment of acute infectious diarrhea in children and the prevention of antibiotic associated diarrhea and nosocomial/community acquired diarrhea. Probiotics prevent relapse of recurrent pouchitis and decrease the initial onset of pouchitis in ulcerative colitis. Probiotic organisms suppress growth of pathogens as well as their epithelial attachment and/or invasion either directly by secreting antimicrobial substances or by stimulating host expression of protective molecules. Additionally, probiotics enhance mucosal barrier function and can stimulate host production of immunosuppressive molecules that downregulate inflammatory responses or allergic immune response. Mechanisms of action explain therapeutic effects and randomized controlled trials are warranted before recommendations for therapeutic or preventive use can be given.

• 한국수의병리학회:학술대회논문집
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• 한국수의병리학회 2003년도 추계학술대회초록집
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• pp.43-43
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• 2003

Porcine epidemic diarrhea (PED), transmissible gastroenteritis (TGE) are an acute viral enteritis. colibacillosis by E coli is a microbial enteritic disease in suckling piglets[1]. These infectious intestinal diarrheal diseases cause severe diarrhea to suckling piglets, so that lead to enormous economical loss in swine-product industries. Ig-Top (AD Biotech, Korea) is a immunomodulator with IgY the specific yolk-antibody for PED, TGE and E. coli and oligosaccharide. The purpose of this study was to investigate protective effects against PED virus, TGE virus E.coli and in suckling piglets by oral administration of the Ig-Top. (omitted)

• Journal of Yeungnam Medical Science
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• 제25권2호
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• pp.182-186
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• 2008

Ulcerative colitis (UC) is a chronic inflammatory disorder of the gastrointestinal tract that affects the large bowel. Its etiology remains controversial. However, an infectious or immunologic origin is considered the primary cause. The onset of UC is typically slow and insidious, but some patients may present acutely with symptoms mimicking infectious colitis. We report a case of ulcerative colitis mimicking acute hemorrhagic colitis at initial presentation. A 60-year-old man was referred to Yeungnam University Hospital for bloody diarrhea and abdominal pain. Sigmoidoscopy revealed mildly edematous mucosa in the rectum and hyperemic mucosa with petechiae in the sigmoid colon. The patient was treated with antibiotics for several days, and his symptoms improved. However, after one month, his bloody diarrhea relapsed. Follow-up sigmoidoscopy revealed mucosal friability in the rectum and sigmoid colon. He was diagnosed with ulcerative colitis, and his symptoms were improved with mesalazine and a steroid enema.