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Multidrug-Resistant Streptococcus pneumoniae Sepsis and Meningitis after Craniofacial Surgery: Case Report (두개안면부 수술 후 발생한 다약제내성폐렴구균패혈증및뇌막염: 증례보고)

  • Kim, Hyung-Suk;Lim, So-Young;Pyon, Jai-Kyong;Mun, Goo-Hyun;Bang, Sa-Ik;Oh, Kap-Sung
    • Archives of Plastic Surgery
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    • v.38 no.4
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    • pp.516-518
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    • 2011
  • Purpose: The prevalence of antibiotic-resistant Streptococcus pneumoniae meningitis has increased worldwide. There are some reports about postoperative antibiotic-resistant Streptococcus pneumoniae infection after craniofacial surgery, but, there is no report in Korea. We present a report on the treatment of postoperative multidrug-resistant Streptococcus pneumoniae (MRSP) meningitis and sepsis after craniofacial surgery based on our experience. Methods: The patient was a 7-year-old boy with Crouzon's disease who was treated by fronto-orbital bar advancement. Intraoperatively, frontal sinus opening was seen during osteotomy which was covered with forehead galeopericranial flap. MRSP meningitis was diagnosed after the surgery, he was treated with intravenous vancomycin, meropenem, and levofloxacin. Results: The patient was treated successfully after 3 weeks of intravenous antibiotics treatment. During the 8 month follow-up period, there was no neurologic sequelae. Conclusion: Postoperative infection after craniofacial surgery is an important phenomenon that needs immediate recognition. Prevention, early diagnosis, and treatment immediate after onset are important as countermeasures against postoperative drug-resistant bacterial infection. To prevent adverse outcome and reoperation, proper antibiotics treatment should be performed.

Primary Sternal Osteomyelitis -A case report- (원발성 흉골 골수염 - 1예 보고-)

  • Yi In-Ho;Youn Hyo-Chul;Kim Dae-Hyun;Kim Soo-Cheol;Cho Kyu-Seok;Park Joo-Chul;Kwak Young-Tae;Kim Bum-Shik
    • Journal of Chest Surgery
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    • v.39 no.4 s.261
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    • pp.340-342
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    • 2006
  • Primary sternal osteomyelitis is a rare disease. Primary sternal osteomyelitis occurring during childhood is extremely rare; therefore, only eleven cases have been reported in the English language literatures. The predisposing factors of primary sternal osteomyelitis are malnutrition, immune deficiency, intravenous injection, blunt chest trauma, and sickle cell anemia. Drainage of pus with antibiotic therapy is the treatment of choice. We report a case of primary sternal osteomyelitis occurred in a 16-year old boy, who had no predisposing factors, with review of literatures.

Inflammatory Myofibroblastic Tumor of the Lung in a Child -A case report- (소아에시 발생한 폐 염증성 근섬유아세포종 -1예 보고-)

  • Kim Hee-Jung;Park Chang-Ryul;Jung Jong-Pil;Shin Je-Kyoun
    • Journal of Chest Surgery
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    • v.39 no.4 s.261
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    • pp.332-334
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    • 2006
  • Inflammatory myofbroblastic tumor in the lung is a rare tumor. The etiology is not clear. This tumor in children is a benign tumor rarely presented with local invasiveness, recurrence, distant metastasis or malignant changes can occur. The complete surgical resection is chosen as the optimal management. A 12-years-old boy visited the outpatient clinic with a 4 cm sized pulmonary mass in left upper lung field. The patient underwent left upper lobectomy. Histopathologically, inflammatory myofibroblastic tumor was confirmed. The patient was discharged without any problems and there was no evidence of recurrence during 3 months follow-up.

Two Cases of Paragonimiasis in Young Siblings Presenting with Pleural Effusion and Subcutaneous Nodules (흉막삼출과 피부결절로 발현한 초등학생 남매의 폐흡충증 2례)

  • Jeong, Moon Young;Baek, Hee Jo;Cho, Duck;Kim, Jin;Hwang, Chan Kyoo;Han, Dong Kyun;Ma, Jae Sook;Kook, Hoon
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1385-1388
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    • 2005
  • Paragonimiasis is the infestation of lung flukes of the trematode genus Paragonimus. This disease is common in Asia, and the southern part of Korea has been known as one of the endemic areas of Paragonimiasis westermanii in Korea. Human infection is associated with specific dietary habits, such as eating freshwater crawfish or crabs. In a 6 1/2-year-old boy with pleural effusion and eosinophilia, paragonimiasis was diagnosed by skin test, serologic exam, and histologic identification of the parasites in a skin lesion. The same diagnosis was entertained in his elder sister with silent pleural effusion. We describe herewith these rare cases of paragonimiasis in two siblings who had a history of eating cooked freshwater crabs.

A Case of Addition of Chromosome 12 associated with Multiple Anomaly and Developmental Impairment (다발성 기형과 발달 장애를 보인 염색체 12번 첨가 1례)

  • Chang, Yoon-Young;Jeong, Ji-Eun;Shin, Jin-Young;Park, Hye-Jin;Lee, Kye-Hyang;Choi, Eun-Jin;Kim, Jin-Kyoung;Chung, Hai-Lee;Seo, Eok-Su;Kim, Woo-Taek
    • Neonatal Medicine
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    • v.15 no.1
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    • pp.89-93
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    • 2008
  • Duplication of chromosome 12p has been rarely reported and are thought to be associated with congenital malformations and impaired development. We report a baby boy born with multiple dysmorphic features and congenital malformations. His karyotype was 46,XY, add(12)(p13.3). He has suffered from intrauterine growth restriction at birth. He showed abnormal cranio-facial findings such as microcephaly, hypognathia, clepft palate and low set ear. He presented with absence of uvula, micropenis and rocker bottom features of both feet, congenital heart disease, poor corticomedullary differentiation of kidney, and sensorineuronal hearing loss. We have been follow up him for seizure disorder and delayed development at out patient department.

A Novel Homozygous LIPA Mutation in a Korean Child with Lysosomal Acid Lipase Deficiency

  • Kim, Kwang Yeon;Kim, Ju Whi;Lee, Kyung Jae;Park, Eunhyang;Kang, Gyeong Hoon;Choi, Young Hun;Kim, Woo Sun;Ko, Jung Min;Moon, Jin Soo;Ko, Jae Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.20 no.4
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    • pp.263-267
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    • 2017
  • Patients with lysosomal acid lipase (LAL) deficiency and glycogen storage disease (GSD) demonstrated hepatomegaly and dyslipidemia. In our case, a 6-year-old boy presented with hepatosplenomegaly. At 3 years of age, GSD had been diagnosed by liver biopsy at another hospital. He showed elevated serum liver enzymes and dyslipidemia. Liver biopsy revealed diffuse microvesicular fatty changes in hepatocytes, septal fibrosis and foamy macrophages. Ultrastructural examination demonstrated numerous lysosomes that contained lipid material and intracytoplasmic cholesterol clefts. A dried blood spot test revealed markedly decreased activity of LAL. LIPA gene sequencing identified the presence of a novel homozygous mutation (p.Thr177Ile). The patient's elevated liver enzymes and dyslipidemia improved with enzyme replacement therapy. This is the first report of a Korean child with LAL deficiency, and our findings suggest that this condition should be considered in the differential diagnosis of children with hepatosplenomegaly and dyslipidemia.

A Case of Tuberculous Otitis Media in Children (소아에서 결핵성 중이염 1례)

  • Kim, Eun Ah;Ham, Se Chang;Kim, Young Kyoun;Park, Yong Won;Kang, Yun Kyung
    • Pediatric Infection and Vaccine
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    • v.9 no.1
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    • pp.110-116
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    • 2002
  • Tuberculous otitis media is a very rare disease in extrapulmonary tuberculosis and in chronic otitis media nowadays. The characteristic signs seem to have altered from the past ones. And the suspicion index is very low that there is often a considerable delay prior to diagnosis. This might result in irreversible complications such as hearing loss, facial nerve paralysis and labyrinthitis. It is difficult to be defined by culture, so many patients with tuberculous otitis media are subjected to have surgery without a correct etiologic diagnosis. Therefore bacteriologic study of secretion and pathologic examinations of biopsied tissue are mandatory. We report one year and 11 months old boy with tuberculous otitis media having painful otorrhea and perforated tympanic membrane diagnosed by histologic finding and polymerase chain reaction(PCR). And we would like to emphasize the fact that tuberculous otitis media must be considered in the differential diagnosis of persistent suppurative otitis media despite appropriate antibiotic therapy considering the increasing tendency in incidence of Tuberculosis in Korea these days.

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Kawasaki Disease Shock Syndrome with Acute Kidney Injury and Hypertension (급성 신손상을 동반한 가와사키 쇼크증후군 1예)

  • Choi, Jae Hong;Kim, Yoon-Joo;Kim, Young Don;Han, Kyoung Hee
    • Pediatric Infection and Vaccine
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    • v.24 no.2
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    • pp.112-116
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    • 2017
  • Kawasaki disease (KD) is an acute febrile mucocutaneous lymph node syndrome that commonly presents with stable hemodynamic status during the acute phase. An 8-year-old boy initially presented with severe hypotension and acute kidney injury. He was placed in the intensive care unit and was diagnosed with KD. Observed clinical features were defined as KD shock syndrome. His coronary artery was dilated during the subacute phase. Furthermore, he was given anti-hypertensive medications, owing to hypertension as an unusual complication of KD. We knew the importance of monitoring for blood pressure considering vasculitis as an aspect of the main pathogenesis of KD.

A Case of Kimura's Disease Occurring During Remission of Steroid-responsive Nephrotic Syndrome (소아에서 스테로이드 반응성 신증후군의 관해기에 발병한 Kimura 병의 1례)

  • Bae Keun-Wook;Lee Min-Kyu;Lee Joo-Hoon;Huh Joo-Ryung;Park Young-Seo
    • Childhood Kidney Diseases
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    • v.10 no.1
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    • pp.52-57
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    • 2006
  • Kimura's disease is a rare chronic inflammatory disease of unknown etiology which appears primarily in young Asian males as non-tender subcutaneous swellings in the head and neck region. Histologic characteristics are the presence of lymphoid follicles, vascular proliferation and infiltration of eosinophils. Peripheral eosinophilia and elevated serum IgE are frequently combined. Systemic steroid therapy with surgical excision is the mainstay of treatment, though recurrence after surgery or discontinued steroid treatment is common. It has been known that about 16% of the cases are associated with renal diseases, particularly nephrotic syndrome. We present an 8-year-old boy with a past history of steroid-responsive, infrequently relapsing nephrotic syndrome who developed right buccal swelling and peripheral eosinophilia during the remission state. He has been managed with surgical resection, steroid and cyclosporine due to multiple recurrences.

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A Case of Idiopathic Renal Hypouricemia with URAT1 Gene Mutation who Showed Persistent Orange-colored Urine (지속적인 주황색 소변을 보인 URAT1 유전자 변이 신성 저요산혈증 1례)

  • Lee Joo-Hoon;Choi Jin-Ho;Yoo Han-Wook;Jeong Jin-Young;Park Young-Seo
    • Childhood Kidney Diseases
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    • v.10 no.1
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    • pp.65-71
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    • 2006
  • Idiopathic renal hypouricemia is a disorder characterized by impaired urate handling in the renal tubules. Most patients with hypouricemia are asymptomatic and are found incidentally, but the condition is known to be at high risk for exercise-induced acute renal failure or urolithiasis. URAT1 protein encoded by SLC22A12 gene has been identified recently as a urate/anion exchanger in the human kidney. Inactivation mutations in SLC22A12 gene have been shown to cause renal idiopathic hypouricemia. We experienced a 3-year-old boy who presented with persistent orange-colored urine since infancy. His urine contained many uric acid crystals, while the serum showed hypouricemia(0.7 mg/dL). The fractional excretion of uric acid was increased to 41.7%. SLC22a12 gene analysis revealed W258X homozygote alleles. Renal hypouricemia must be included in the differential diagnosis of red-urine and SLC22A12 gene analysis is recommended in idiopathic renal hypouricemia.

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