Tuberculosis (TB) is still a significant public health problem in Korea. In many cases, it is not easy to diagnose TB. A 13-year-old male patient was admitted for left chest pain for 6 months period. Chest radiography done two months ago during the school screening revealed a pleural effusion in the left lung. All cultures were negative, and 3 sputum samples and his pleural fluid sample tested negative for Acid-fast bacilli. There was no evidence of a malignant effusion. A pleural fluid examination revealed features suggestive of an empyema. Thick and yellowish pus was drawn out. Pleural fluid analysis presented White blood cell 5,200/mm3, and neutrophil-dominant with 60% of neutrophil. In an effort to attain a diagnosis, a video-assisted thoracoscopy procedure was performed with pleural drainage and biopsies. Active chronic granulomatous pleuritis was found through pleural biopsies. He was responsive to treatment and received 6 months of anti-TB therapy with complete clinical resolution. If the clinical picture is in confusion, pleural biopsy is occasionally indicated to diagnose TB pleuritis.

Eosinophilic gastroenteritis (EGE) is a rare inflammatory disorder that predominantly affects the stomach and the small intestine, although its pathogenesis is not yet known precisely. EGE shows distinct peripheral eosinophilia and eosinophilic infiltration of the intestinal wall. A 12-month-old girl who was breastfeeding presented with bilateral eyelid swelling without gastrointestinal symptom. Laboratory examination showed peripheral eosinophilia and hypoalbuminemia and iron deficiency anemia. Gastric and duodenal biopsy specimens revealed eosinophilic infiltration of the mucosal layer. We experienced a case of eosinophilic gastroenteritis without any gastrointestinal symptom, associated with maternal food contained allergen.

Acute disseminated encephalomyelitis (ADEM) is a rare, postinfectious autoimmune inflammatory demyelinating disease of the central nervous system. ADEM presents clinically encephalopathy in association with polyfocal neurologic deficits. Of them, optic neuritis is less common symptom. We experienced ADEM with optic neuritis associated with Mycoplasma pneumoniae infection in a 5 year-old girl. She initially presented lethargy, irritability, ataxia and loss of pain sense on right hand and progressed to decreased visual acuity and papilledema of both eyes on the 4th hospital day. Brain magnetic resonance imaging showed multiple bilateral hyperintense lesions in the subcortical white matter on T2 weighted images. After administration of intravenous immunoglobulin and high dose intravenous methylprednisolone, she recovered completely.

The aim of this study was to determine the effect of acute respiratory viral infection on Kawasaki disease. From July 2016 to June 2018, among the patients who underwent respiratory virus screening at the Kwangju Christian Hospital, those diag-nosed 88 patients with Kawasaki disease were enrolled in this study. The effects of acute respiratory viral infection on Ka-wasaki disease were compared according to whether 2nd intravenous immunoglobulin (IVIG) treatment was administered or not, and whether coronary artery complications occurred. Respiratory virus was detected in 44 out of 88 patients. 2nd IVIG treatment rates were 16% (n=7) and 27% (n=12) in the virus positive group and the virus negative group, respectively (p>0.05). The incidence of coronary artery complications was 11% (n=5) and 25% (n=11) in the virus positive group and the virus negative group, respectively (p>0.05). There was no statistically significant correlation between the 2nd IVIG admin-istration and coronary artery complications following the detection of respiratory virus in patients with Kawasaki disease. We think it is necessary to actively study the effects of acute respiratory viral infection on Kawasaki disease through large-scale studies of multiple centers in the future.

The study aimed to evaluate the usability of sterile bag collection (SBC) urinalysis and urine culture for diagnosing urinary tract infections (UTI). Urine culture is key for diagnosing UTI, and transurethral catheterization (TUC) or suprapubic aspiration is recommended for non-toilet-trained children. Although urine testing using SBC is non-invasive and easy, UTI can be diagnosed only if other criteria including clinical symptoms and positive urinalysis results are met. This study included 228 infants who were hospitalized for unexplained fever from October 2015 to June 2016. TUC culture, SBC urinalysis, and urine culture were performed for all patients. UTI was diagnosed when the TUC culture results met the criterion of ≥104 colony-forming units (CFU)/mL. When UTI diagnosis was made based on SBC urine colony counts ≥105 CFU/mL, the false-positive and false-negative rates were 6.3% and 70.0%, respectively. When the criterion was set as ≥104 CFU/mL, they were 23.7% and 30.0%, respectively. When both the criteria of ≥105 CFU/mL and positive urinalysis results were met, the false-positive rate was 2.4%, and the false-negative rate was 80%. Our results suggest that diagnosing UTI using SBC urinalysis and urine culture is not useful in infants with unexplained fever.

This study aimed to identify the respiratory viral etiology and clinical features in febrile neonates and young infants younger than 3 months of age. From June 2015 to March 2016, 126 patients who admitted to the pediatrics department of Kwangju Christian Hospital due to febrile illness (body temperature ≥ 38.0℃) without definite focus of fever. We tested nasopharyngeal aspiration specimens with real time reverse transcriptase polymerase chain reaction. Respiratory viruses identified in 66 patients, and not identified in 60 patients. Among identified viruses, the most common pathogen was rhinovirus. Respiratory virus identified patients showed significantly higher presence of sibling (p=0.015), sibling who attending day care center (p=0.022), respiratory symptoms of family members (p=0.022), concomitant respiratory symptoms of the patient (p=0.001).

Enterobius vermicularis is one of the most common parasites in the world and the infection rate is higher in children than adults. Although the most common clinical manifestation is perianal pruritus, it may cause other gastrointestinal manifestations. We report one case of appendicitis caused by Enterobius vermicularis. The clinical difference between typical appendicitis and the appendicitis due to Enterobius vermicularis is unclear. The patient had a repetitive Enterobius vermicularis infection for a past year, which was treated with occasional vermicides only. It is considered that the appendicitis is developed from the intractable Enterobius vermicularis infection.

The intussusception recurs in approximately 10 percent of children after successful nonoperative reduction. The main objective was to determine the clinical and sonographic findings that could be used to predict recurrence of ileocolic intussusception in children that had been successfully reduced by enema. A retrospective search was performed on 66 children, at age of 3 months to 7 years, with successful enema reduction of intussusception during a 2.5-year period from January 2013 to July 2015. The clinical, laboratory records, and sonographic findings were compared between recurrence of intussusceptions group (ROI) and non-recurrence group (NROI). Statistical significances were found in age (median, 26.0 vs 18.5 months; P =0.022) and terminal ileal wall thickening (mean, 10.23 vs 7.8 mm; p=0.002); in contrast, there was no significance considering gender, irritability (p=0.074), currant jelly stool (p=1.0), or C-reactive protein (p=0.908). Recurrence is associated with age and the thickening of terminal ileal wall, but clinical or laboratory findings. Given the small number of cases, further studies should be conducted.

Prevalence of Mycoplasma pneumoniae pneumonia in preschool children has shown a recent increase and macrolideresistant Mycoplasma pneumoniae pneumonia has been reported. We investigated the clinical features of Mycoplasma pneumoniae pneumonia among children of different ages and different years for the most recent seven years. Retrospective analysis was performed on the clinical data of 735 children who were hospitalized due to Mycoplasma pneumoniae pneumonia between January 2006 and December 2012. The children were divided into three groups according to age: the A group (<3 years), B group (≥3 years and <7 years), and C group (≥7 years). In addition, the children were divided into two groups according to the year in which the disease had developed: the early period (2006 and 2007 year), and the late period (from 2010 to 2012 year). The infant group (A group) presented mainly with a shorter duration of fever and more frequent wheezing. In the late period, the interval until improvement after a macrolide was prescribed increased. Clinical features of Mycoplasma pneumoniae pneumonia differed among children of different ages, particularly between infants and school-aged children.