Achromobacter xylosoxidans Bacteremia in a Child with Neutropenia

Achromobacter xylosoxidans is a non-fermentative, aerobic, oxidase, and catalase-positive Gram-negative rod similar to Pseudomonas species. This organism colonizes aquatic environments and can cause nosocomial infections, especially in patients with immune deficiency such as human immunodeficiency virus infection, cancer, cystic fibrosis, neutropenia, and immunoglobulin M deficiency. Infections are found as bacteremia, pneumonia, meningitis, urinary tract infection, abscess formation, and osteomyelitis. It is known that most effective antibiotics are piperacillin/tazobactam, meropenem, and trimethoprim/sulfamethoxazol. But there is no optimal antibiotic therapy so far. We present a case of Achromobacter xylosoxidans bacteremia in a 13-month-old Korean girl who had past history of neutropenia.

Rosai-Dorfman Disease of 4-Year-Old Girl

Rosai-Dorfman disease also known as sinus histiocytosis with massive lymphadenopathy is a benign, rare systemic disease characterized by a histiocyte proliferation which presents with lymphadenopathy. We report a case of a 4-year-old girl who presented with recurrent cervical lymphadenopathy with tenderness, without any other symptoms. After 1 month of medical treatment, her lymphadenopathy still remained, so we performed complete excision and biopsy. She was diagnosed on cytology as a case of Rosai-Dorfman disease. She responded well to become asymptomatic without recurrence by 1 month.

Pediatric anaphylaxis at a university hospital including the rate of prescribing epinephrine auto-injectors

PURPOSE: Anaphylaxis is an acute, life-threatening systemic reaction which should be treated by epinephrine, and patients should be prescribed epinephrine auto-injector after the event. The purpose of this study was to investigate the clinical features of pediatric anaphylaxis, including the rate of using epinephrine at hospital and prescribing epinephrine auto-injector. METHODS: We performed a retrospective study of 68 anaphylactic patients at in-hospital, out-hospital, and Emergency Department of Soonchunhyang University Cheonan Hospital, Cheonan, Korea, who were under 15 years of age, from January 2013 through December 2014. We reviewed their clinical features, doctor's treatment methods, rate of follow-up and prescribing epinephrine auto-injectors. RESULTS: Causes of anaphylaxis were food (76.5%), drug (10.3%), and idiopathic (13.2%). The involved organs were the skin (86.8%), respiratory tract (80.9%), cardiovascular system (23.5%), and gastrointestinal tract (17.7%). Patients were treated with systemic steroids (91.2%), antihistamines (88.2%), and epinephrine (75.0%). Fifty-three patients (77.9%) revisited our pediatric allergy clinic and epinephrine auto-injectors were prescribed for 25 patients (36.8%). CONCLUSION: Physicians should make an effort to use epinephrine as an initial treatment of anaphylaxis, to prescribe epinephrine auto-injectors, and to give proper information about disease.

Study for the Sensitization Rate of Garlic and Onion Using Multiple Allergen Simultaneous Test-Immunoblot Assay

OBJECTIVE: Onion and garlic are a commonly consumed food in the Korean population. But these food materials have rarely been studied for their allergenic potentials. We analyzed the sensitization rate of garlic and onion using multiple allergen simultaneous test (MAST)-immunoblot assay. METHODS: From January 2009 to December 2013, we analyzed the results of the MAST immunoblot assay performed in 2,691 allergy patients at Soonchunhyang University Cheonan Hospital, retrospectively. RESULTS: Among 2,691 patients, 1,063 were under 18 years old, and 1,628 were over 18 years old. In the all age groups, 29 patients (1.08%) were positive to garlic, 54 patients (2.01%) were positive to onion and one patient was positive to garlic and onion and others. A total of 84 patients (3.12%) were positive to garlic or onions. In infants under the age of 2 years, garlic was the seventh and onion was the nineteenth common food allergen, and onion was more common than rice. While getting older, the sensitization rate of garlic decreased (P<0.001), but onion increased (P<0.01). CONCLUSION: Using one of the semi-quantitative methods, MAST immunoblot assay, we realized that the sensitization rate of garlic was higher than rice or wheat in infants. We presume further studies on the role of garlic and onion in food allergy are needed.