Five Year Experience of Preexposure and Postexposure Rabies Prophylaxis in Korean Children at the National Medical Center / 소아감염

PURPOSE: This study aims to investigate preexposure prophylaxis and postexposure prophylaxis of rabies that the National Medical Center (NMC) handled and to check whether appropriate measures were performed according to the recent domestic and overseas guidelines after animal bites. METHODS: This study surveyed 41 people who were 18 years or under and received preexposure and postexposure prophylaxis of rabies at the NMC from November 2006 to December 2011. Their medical records were reviewed for their age, gender, the reason for preexposure prophylaxis, the body sites of animal bite, the kind of the animal that bit children, the region where the biting occurred and rabies vaccination and inoculation of immunoglobulin. RESULTS: Eleven children took rabies vaccination for preexposure prophylaxis and 30 children received post exposure prophylaxis of rabies. Of patients who were bitten by unvaccinated animals including wild animals or by animals which were not certain to be vaccinated, 50% (13 of 26 children) received postexposure prophylaxis, while 75% (3 of 4 children) of patients who were bitten by vaccinated animals received postexposure prophylaxis of rabies. Ten of 30 bitten patients knew whether or not the biting animals had received rabies vaccination. Of them, four people (40%) were bitten by animals which had received rabies vaccination. CONCLUSION: To prevent the occurrence of rabies, people and health care providers need to correctly understand latest guideline for rabies preexposure and postexposure prophylaxis and the information for bitten patient, biting animal and area at bitten by animal should be accurately recorded.

Clinical Features of Patients with Anaphylaxis at a Single Hospital / 소아알레르기및호흡기학회지

PURPOSE: The studies concerning the clinical features of patients with anaphylaxis, who meet the newly established diagnostic criteria, are reported in Korea, but comparative studies regarding the clinical features of children and adult patients with anaphylaxis are lacking. The purpose of this study is to compare the clinical features of the children and adults with anaphylaxis, who meet the new diagnostic criteria at a single hospital. METHODS: We reviewed the medical records of patients who were diagnosed with anaphylaxis, anaphylactic shock, urticaria, and angioedema, including inpatients, outpatients and emergency room visited patients, at the National Medical Center from July, 2005 to August, 2011. The clinical characteristics of children and adults, who met the new diagnostic criteria for anaphylaxis, were analyzed. RESULTS: We identified 91 patients with anaphylaxis. Sixteen were children and 75 were adults. The sex ratio (male:female) and the mean age were 1:1.7 and 9.6 years among children, respectively, and 1:2.3 and 42.3 years, respectively, among adults. The most common cause of anaphylaxis based on clinical history was foods in 15 children (93.7%) and 35 adults (46.7%). Twelve children (75%) and 36 adults (48%) were rediagnosed with anaphylaxis. Patients with cardiovascular symptoms and severe severity were 1 (6.3%) and 1 (6.3%), respectively, among children, and 28 (37.3%) and 23 (30.3%), respectively, among adults. CONCLUSION: We rediagnosed some cases of anaphylaxis, using the new diagnostic criteria and most of the cases were diagnosed initially as urticaria or angioedema. The adults had more severe and more cardiovascular symptoms than children. In the future, a nationwide, multiinstitutional research will be necessary for the prevalence and the clinical features of anaphylaxis by the new diagnostic criteria in Korea.

A Case of Epstein-Barr Virus Infection with Gall Bladder and Common Bile Duct Stones in an Otherwise Healthy Child / 대한소아소화기영양학회지

Cholelithiasis and choledocholithiasis are uncommon pediatric diseases, although clinicians have seen them with increasing frequency in children in recent years. Moreover, no case of Epstein-Barr virus (EBV) infection with cholelithiasis and choledocholithiasis has been previously reported in the English literature. We report a pediatric patient with EBV infection, a gall bladder stone, and a common bile duct stone, may have had GB and CBD stones prior to her EBV infection, whom we successfully treated with antibiotics and laparoscopic cholecystectomy for cholecystitis.