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Review Article
Research trends on causes of Kawasaki disease in the COVID-19 era: focus on viral infections
Young Hwan Lee
Despite studies on the etiology of Kawasaki disease (KD) ongoing for half a century since its discovery, its cause has not yet been clearly identified. Although the clinical, epidemiological, and pathophysiological characteristics of KD are presumed to be closely related to infectious diseases, studies of various pathogens to identify its etiology have been actively conducted. To date, bacteria, fungi, and...
Original Article
Emergency Medicine
Comparison of clinical features and laboratory findings of coronavirus disease 2019 and influenza A and B infections in children: a single-center study
Meraj Siddiqui, Ayşe Gültekingil, Oğuz Bakırcı, Nihal Uslu, Esra Baskın
Clin Exp Pediatr. 2021;64(7):364-369.   Published online May 18, 2021
Question: What are the differences between coronavirus disease 2019 (COVID-19) and influenza infections in children?
Finding: Pediatric COVID-19 patients predominantly exhibited respiratory and/or gastrointestinal symptoms, neurological manifestations, olfactory/gustatory dysfunction, elevated monocytes, mildly elevated C-reactive protein, and unilateral or diffuse abnormalities on chest x-ray. Patients with underlying medical conditions had higher intensive care unit admission rates and should be followed closely.
Meaning: The clinical presentations of pediatric COVID-19 patients varied from asymptomatic/mild to severe.
Review Article
Infection
Effects of nasopharyngeal microbiota in respiratory infections and allergies
Hyun Mi Kang, Jin Han Kang
Clin Exp Pediatr. 2021;64(11):543-551.   Published online April 15, 2021
· The nasal microbiota varies with age and is shaped by various factors in healthy individuals.
· The pathological condition of the respiratory tract appears to be associated with reduced nasal microbiota biodiversity, while dysbiosis is involved in the pathophysiology of many respiratory diseases, including otitis, sinusitis, allergic diseases, and lower respiratory infections.
Original Article
General Pediatrics
Risk factors for childhood pneumonia: a case-control study in a high prevalence area in Indonesia
Vivi Ninda Sutriana, Mei Neni Sitaresmi, Abdul Wahab
Clin Exp Pediatr. 2021;64(11):588-595.   Published online March 15, 2021
Question: Is the incidence of childhood pneumonia influenced by breastfeeding and basic immunization status?
Finding: Exclusive breastfeeding and complete basic immunization status have an effect in limiting the incidence of childhood pneumonia.
Meaning: While exclusive breastfeeding and complete basic immunization the Expanded Program on Immunization status are important factors for reducing the incidence of childhood pneumonia, indoor air pollution was also a significant risk factor.
Nephrology (Genitourinary)
Urinary neutrophil gelatinase-associated lipocalin: a marker of urinary tract infection among febrile children
Ji Hyun Moon, Kee Hwan Yoo, Hyung Eun Yim
Clin Exp Pediatr. 2021;64(7):347-354.   Published online October 17, 2020
Question: Reliably diagnosing urinary tract infection (UTI) in febrile children is often difficult. Can urinary neutrophil gelatinase-associated lipocalin (uNGAL) better predict UTI and acute pyelonephritis (APN) than serum C-reactive protein (CRP) and white blood cell (WBC) count?
Finding: uNGAL better facilitated the prediction of UTI and APN, than serum CRP and WBC counts in febrile children.
Meaning: uNGAL is a suitable biomarker for UTI and APN in febrile children.
Review Article
Gastroenterology
Changing prevalence of Helicobacter pylori infection in children and adolescents
Ji Sook Park, Jin Su Jun, Ji-Hyun Seo, Hee-Shang Youn, Kwang-Ho Rhee
Clin Exp Pediatr. 2021;64(1):21-25.   Published online July 15, 2020
Although Helicobacter pylori infection rate in children is unclear due to diversity and limitation of diagnostic tests unlike in adults, investigation the childhood prevalence is important for predicting H. pylori-related diseases in the future.
H. pylori infection occurred in early childhood, and declined during 30 years in our study.
Change in risk factors of H. pylori transmission and consensus for eradication therapy in children might further reduce the infection rate.
Original Article
Critical Care Medicine
Can central venous access device care bundles and regular feedback reduce central line-associated complications in pediatric patients?
Chanapai Chaiyakulsil, Onsuthi Pharadornuwat
Clin Exp Pediatr. 2021;64(3):123-129.   Published online July 14, 2020
Question: Can central line bundles and feedback reduce central line-associated complications in pediatric patients?
Finding: The central line-related bloodstream infection rate decreased from 10.0 catheter-days to 1.4/1,000 catheter-days at 6-month postintervention. The central line occlusion rate was also decreased.
Meaning: Reinforcing central line care bundles with direct feedback can significantly decrease central line-associated complications in pediatric patients.
Nutrition
Positive association of breastfeeding on respiratory syncytial virus infection in hospitalized infants: a multicenter retrospective study
Min Jeong Jang, Yong Joo Kim, Shinhye Hong, Jaeyoon Na, Jong Hee Hwang, Son Moon Shin, Young Min Ahn
Clin Exp Pediatr. 2020;63(4):135-140.   Published online November 12, 2019
Question: Human milk has stronger antiviral, antibacterial, and anti-inflammatory properties compared with formula milk. How dose breastfeeding affect respiratory syncytial virus infection in Korea?
Finding: Breastfed infants required less oxygen therapy and possible intensive care unit admission than artificial formulafed infants during respiratory syncytial virus infection.
Meaning: This protective role of breast milk on RSV severity can be a supporting evidence for promoting breastfeeding in Korea.
Cardiology
High antistreptolysin O titer is associated with coronary artery lesions in patients with Kawasaki disease
Dong Eun Min, Do Hee Kim, Mi Young Han, Sung Ho Cha, Kyung Lim Yoon
Clin Exp Pediatr. 2019;62(6):235-239.   Published online November 7, 2018

Purpose: In Kawasaki disease (KD) patients, coronary artery complications, incomplete and refractory types occur more frequently in patients with streptococcal or other bacterial/viral infections. Recently, we observed a higher incidence of coronary lesions in KD patients with high anti-streptolysin O (ASO) titer. Therefore, we hypothesized that KD patients diagnosed with concurrent streptococcal infection have poor prognosis, with respect to treatment...
Pulmonology
The changes of prevalence and etiology of pediatric pneumonia from National Emergency Department Information System in Korea, between 2007 and 2014
Eun Ju Shin, Yunsun Kim, Jin-Young Jeong, Yu Mi Jung, Mi-Hee Lee, Eun Hee Chung
Clin Exp Pediatr. 2018;61(9):291-300.   Published online September 15, 2018

Purpose: Understanding changes in pathogen and pneumonia prevalence among pediatric pneumonia patients is important for the prevention of infectious diseases. Methods: We retrospectively analyzed data of children younger than 18 years diagnosed with pneumonia at 117 Emergency Departments in Korea between 2007 and 2014. Results: Over the study period, 329,380 pediatric cases of pneumonia were identified. The most frequent age group was...
Infection
Association between vitamin D and urinary tract infection in children
Abolfazl Mahyar, Parviz Ayazi, Sara Safari, Reza Dalirani, Amir Javadi, Shiva Esmaeily
Clin Exp Pediatr. 2018;61(3):90-94.   Published online March 19, 2018
Purpose

The present study aimed to determine the relationship between serum 25-hydroxyvitamin D (25(OH)D) level and Urinary tract infections (UTIs) in children.

Methods

In this case-control study, 70 children with UTI (case group) were compared with 70 healthy children (control group) in terms of serum 25(OH)D levels. The children were between 1 month and 12 years of age. Serum 25(OH)D levels were measured...

Cardiology
Discrimination of Kawasaki disease with concomitant adenoviral detection differentiating from isolated adenoviral infection
Jong Han Kim, Hye Ree Kang, Su Yeong Kim, Ji-Eun Ban
Clin Exp Pediatr. 2018;61(2):43-48.   Published online February 28, 2018
Purpose

Human adenovirus infection mimics Kawasaki disease (KD) but can be detected in KD patients. The aim of this study was to determine the clinical differences between KD with adenovirus infection and only adenoviral infection and to identify biomarkers for prediction of adenovirus-positive KD from isolated adenoviral infection.

Methods

A total of 147 patients with isolated adenovirus were identified by quantitative polymerase chain...

Nephrology (Genitourinary)
Diagnostic accuracy of urinary biomarkers in infants younger than 3 months with urinary tract infection
Nani Jung, Hye Jin Byun, Jae Hyun Park, Joon Sik Kim, Hae Won Kim, Ji Yong Ha
Clin Exp Pediatr. 2018;61(1):24-29.   Published online January 22, 2018
Purpose

The aim of this study was to evaluate the diagnostic accuracy of urinary biomarkers, such as neutrophil gelatinase-associated lipocalin (uNGAL) and β-2 microglobulin (uB2MG), in early detection of urinary tract infection (UTI) in infants aged <3 months with fever.

Methods

A total of 422 infants aged <3 months (male:female=267:155; mean age, 56.4 days), who were admitted for fever, were retrospectively included in...

Is vaginal reflux associated with urinary tract infection in female children under the age of 36 months?
Yu Bin Kim, Chih Lung Tang, Ja Wook Koo
Clin Exp Pediatr. 2018;61(1):17-23.   Published online January 22, 2018
Purpose

To determine the relationship between vaginal reflux (VR) and urinary tract infection (UTI) in female children aged <36 months.

Methods

A single center retrospective study was performed for 191 girls aged <36 months, with a diagnosis of febrile UTI, who underwent a voiding cystourethrography (VCUG) for assessment of vesicoureteral reflux (VUR) at Sanggye Paik Hospital. Fifty-one girls, who underwent VCUG for assessment...

Infection
Uropathogenic Escherichia coli ST131 in urinary tract infections in children
Ki Wook Yun, Mi-Kyung Lee, Wonyong Kim, In Seok Lim
Clin Exp Pediatr. 2017;60(7):221-226.   Published online July 31, 2017
Purpose

Escherichia coli sequence type (ST) 131, a multidrug-resistant clone causing extraintestinal infections, has rapidly become prevalent worldwide. However, the epidemiological and clinical features of pediatric infections are poorly understood. We aimed to explore the characteristics of ST131 Escherichia coli isolated from Korean children with urinary tract infections.

Methods

We examined 114 uropathogenic E. coli (UPEC) isolates from children hospitalized at Chung-Ang University...

Cardiology
Clinical usefulness of serum procalcitonin level in distinguishing between Kawasaki disease and other infections in febrile children
Na Hyun Lee, Hee Joung Choi, Yeo Hyang Kim
Clin Exp Pediatr. 2017;60(4):112-117.   Published online April 25, 2017
Purpose

The aims of this study were to compare serum procalcitonin (PCT) levels between febrile children with Kawasaki disease (KD) and those with bacterial or viral infections, and assess the clinical usefulness of PCT level in predicting KD.

Methods

Serum PCT levels were examined in febrile pediatric patients admitted between August 2013 and August 2014. The patients were divided into 3 groups as...

Infection
Etiology and clinical characteristics of fever of unknown origin in children: a 15-year experience in a single center
Yi-Seul Kim, Kyung-Ran Kim, Ji-Man Kang, Jong-Min Kim, Yae-Jean Kim
Clin Exp Pediatr. 2017;60(3):77-85.   Published online March 27, 2017
Purpose

Fever is one of the most common symptoms in children. In previous studies, infectious disease was the most common cause of pediatric fever of unknown origin (FUO). The aim of this study is to investigate the etiology, clinical characteristics and prognosis of pediatric FUO in 21 century with more diagnostics available and to analyze the factors for certain disease categories.

Methods

Among...

Usefulness of interferon-γ release assay for the diagnosis of latent tuberculosis infection in young children
Ki Wook Yun, Young Kwang Kim, Hae Ryun Kim, Mi Kyung Lee, In Seok Lim
Clin Exp Pediatr. 2016;59(6):256-261.   Published online June 30, 2016
Purpose

Latent tuberculosis infection (LTBI) in young children may progress to severe active tuberculosis (TB) disease and serve as a reservoir for future transmission of TB disease. There are limited data on interferon-γ release assay (IGRA) performance in young children, which our research aims to address by investigating the usefulness of IGRA for the diagnosis of LTBI.

Methods

We performed a tuberculin skin...

Nephrology (Genitourinary)
Usefulness of neutrophil-lymphocyte ratio in young children with febrile urinary tract infection
Song Yi Han, I Re Lee, Se Jin Park, Ji Hong Kim, Jae Il Shin
Clin Exp Pediatr. 2016;59(3):139-144.   Published online March 31, 2016
Purpose

Acute pyelonephritis (APN) is a serious bacterial infection that can cause renal scarring in children. Early identification of APN is critical to improve treatment outcomes. The neutrophil-lymphocyte ratio (NLR) is a prognostic marker of many diseases, but it has not yet been established in urinary tract infection (UTI). The aim of this study was to determine whether NLR is a...

Evaluation of new American Academy of Pediatrics guideline for febrile urinary tract infection
Da Min Choi, Tae Hoon Heo, Hyung Eun Yim, Kee Hwan Yoo
Clin Exp Pediatr. 2015;58(9):341-346.   Published online September 21, 2015
Purpose

To evaluate the practical applications of the diagnosis algorithms recommended by the American Academy of Pediatrics urinary tract infection (UTI) guideline.

Methods

We retrospectively reviewed the medical records of febrile UTI patients aged between 2 and 24 months. The patients were divided into 3 groups: group I (patients with positive urine culture and urinalysis findings), group II (those with positive urine culture...

Clinical risk factors associated with the development of wheezing in children less than 2 years of age who required hospitalization for viral lower respiratory tract infections
Joon Hwan Kim, Ji-Yeon Choi, Na Yeon Kim, Jin Woo Kim, Ji Hyeon Baek, Hye Sung Baek, Jung Won Yoon, Hye Mi Jee, Sun Hee Choi, Hyeung Yoon Kim, Ki Eun Kim, Youn Ho Shin, Man Yong Han
Clin Exp Pediatr. 2015;58(7):245-250.   Published online July 22, 2015
Purpose

Wheezing following viral lower respiratory tract infections (LRTIs) in children <2 years of age is an important risk factor for the development of asthma later in life; however, not all children with viral LRTIs develop wheezing. This study investigated risk factors for the development of wheezing during viral LRTIs requiring hospitalization.

Methods

The study included 142 children <2 years of age hospitalized...

Validity of bag urine culture for predicting urinary tract infections in febrile infants: a paired comparison of urine collection methods
Geun-A Kim, Ja-Wook Koo
Clin Exp Pediatr. 2015;58(5):183-189.   Published online May 22, 2015
Purpose

Catheter urine (CATH-U) and suprapubic aspiration (SPA) are reliable urine collection methods for confirming urinary tract infections (UTI) in infants. However, noninvasive and easily accessible collecting bag urine (CBU) is widely used, despite its high contamination rate. This study investigated the validity of CBU cultures for diagnosing UTIs, using CATH-U culture results as the gold standard.

Methods

We retrospectively analyzed 210 infants,...

Case Report
Neonatal invasive Streptococcus gallolyticus subsp. pasteurianus infection with delayed central nervous system complications
Jung-Weon Park, So-Hee Eun, Eui-Chong Kim, Moon-Woo Seong, Yun-Kyung Kim
Clin Exp Pediatr. 2015;58(1):33-36.   Published online January 31, 2015

Group D streptococci are known to cause newborn septicemia and meningitis, but the Streptococcus bovis group strains rarely cause serious neonatal infections in Korea. Central nervous system (CNS) complications of neonatal S. bovis group infection have rarely been reported. In adults, S. bovis group strains cause bacteremia and endocarditis, and are associated with gastrointestinal malignancy. However, only a few studies...

Chronic Epstein-Barr virus infection causing both benign and malignant lymphoproliferative disorders
Yoojin Kwun, Soo-Jong Hong, Jin Seong Lee, Da Hye Son, Jong Jin Seo
Clin Exp Pediatr. 2014;57(9):420-424.   Published online September 30, 2014

The Epstein-Barr virus (EBV) is oncogenic and can transform B cells from a benign to a malignant phenotype. EBV infection is also associated with lymphoid interstitial pneumonia (LIP). Here, we report the case of a 14-year-old boy who was diagnosed with a latent EBV infection and underlying LIP, without any associated immunodeficiency. He had been EBV-seropositive for 8 years. The...

Original Article
Ten years of experience in the prevention of mother-to-child human immunodeficiency virus transmission in a university teaching hospital
Jung-Weon Park, Tae-Whan Yang, Yun-Kyung Kim, Byung-Min Choi, Hai-Joong Kim, Dae-Won Park
Clin Exp Pediatr. 2014;57(3):117-124.   Published online March 31, 2014
Purpose

Administration of antiretroviral drugs to mothers and infants significantly decreases mother-to-child human immunodeficiency virus (HIV) transmission; cesarean sections and discouraging breastfeeding further decreases this risk. The present study confirmed the HIV status of babies born to mothers infected with HIV and describes the characteristics of babies and mothers who received preventive treatment.

Methods

This study retrospectively analyzed medical records of nine infants...

Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA)
Youn Ho Shin, Jinho Yu, Kyung Won Kim, Kangmo Ahn, Seo-Ah Hong, Eun Lee, Song-I Yang, Young-Ho Jung, Hyung Young Kim, Ju-Hee Seo, Ji-Won Kwon, Byoung-Ju Kim, Hyo-Bin Kim, Jung Yeon Shim, Woo Kyung Kim, Dae Jin Song, So-Yeon Lee, Soo Young Lee, Gwang Cheon Jang, Dong In Suh, Hyeon-Jong Yang, Bong Sung Kim, Suk-Joo Choi, Soo-Young Oh, Ja-Young Kwon, Kyung-Ju Lee, Hee Jin Park, Pil Ryang Lee, Hye-Sung Won, Soo-Jong Hong
Clin Exp Pediatr. 2013;56(10):439-445.   Published online October 31, 2013
Purpose

Previous studies suggest that the concentration of 25-hydroxyvitamin D [25(OH)D] in cord blood may show an inverse association with respiratory tract infections (RTI) during childhood. The aim of the present study was to examine the influence of 25(OH)D concentrations in cord blood on infant RTI in a Korean birth cohort.

Methods

The levels of 25(OH)D in cord blood obtained from 525 Korean...

The control of invasive Candida infection in very low birth weight infants by reduction in the use of 3rd generation cephalosporin
Yu Jin Chang, Il Rak Choi, Won Sub Shin, Jang Hoon Lee, Yun Kyung Kim, Moon Sung Park
Clin Exp Pediatr. 2013;56(2):68-74.   Published online February 25, 2013
Purpose

To evaluate the effectiveness of new management policies on the incidence of invasive Candida infections

Methods

This observational study involved a retrospective analysis of the patients' medical records. In total, 99 very low birth weight infants, who were admitted to the neonatal intensive care unit at Ajou University Hospital from January 2010 to December 2011, were enrolled for the study. Period I,...

Detection rate and clinical impact of respiratory viruses in children with Kawasaki disease
Ja Hye Kim, Jeong Jin Yu, Jina Lee, Mi-Na Kim, Hong Ki Ko, Hyung Soon Choi, Young-Hwue Kim, Jae-Kon Ko
Clin Exp Pediatr. 2012;55(12):470-473.   Published online December 20, 2012
Purpose

The purpose of this prospective case-control study was to survey the detection rate of respiratory viruses in children with Kawasaki disease (KD) by using multiplex reverse transcriptase-polymerase chain reaction (RT-PCR), and to investigate the clinical implications of the prevalence of respiratory viruses during the acute phase of KD.

Methods

RT-PCR assays were carried out to screen for the presence of respiratory syncytial...

Regional differences in phylogenetic group of Escherichia coli strains isolated from children with urinary tract infection in Korea
Ui-Yoon Choi, Seung Beom Han, Soo Young Lee, Jin Han Kang, Sun Mi Kim, Sang Hyuk Ma
Clin Exp Pediatr. 2012;55(11):420-423.   Published online November 23, 2012
Purpose

We phylogenetically analyzed the Escherichia coli strains isolated from children with urinary tract infection (UTI) in 2 regions of Korea. Virulence factors (VFs) and antibiotic resistance of the strains were also determined to compare the possible differences.

Methods

A total of 138 E. coli strains were collected from the 2 regions; Gyeongin (78 strains) and Gyeongnam (60 strains). The phylogenetic groups were...

Review Article
Renal scar formation after urinary tract infection in children
Young Seo Park
Clin Exp Pediatr. 2012;55(10):367-370.   Published online October 29, 2012

Urinary tract infection (UTI) is a common bacterial illness in children. Acute pyelonephritis in children may lead to renal scarring with the risk of later hypertension, preeclampsia during pregnancy, proteinuria, and renal insufficiency. Until now, vesicoureteral reflux (VUR) has been considered the most important risk factor for post-UTI renal scar formation in children. VUR predisposes children with UTI to pyelonephritis,...

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