Journal of the Korean Pediatric Society 1980;23(5):376-383.
Published online May 15, 1980.
A Clinical Study on Sepsis in Children: esp. about buffy coat smear.
Nam Keun Cho1, Haeng Mi Kim1, Sang Bum Lee1, Ja Hoon Koo1, Sung Yong Seol2
1Department of Pediatrics, College of Medicine Kyungpook National University, Korea.
2Department of Microbiology, College of Medicine Kyungpook National University, Korea.
小兒 敗血症에 關한 臨床的 硏究
趙南根1, 金幸美1, 李相範1, 具慈薰1, 薛盛用2
1慶北醫大 小兒科學敎室
2慶北醫大 微生物學敎室
Abstract
A clinical and laboratory study was conducted on 58 children who had been admitted to out pediatric department from February to September 1979, under the clinical diagnosis of septicemia. Following results were obtained: 1. Boys were affected more frequently than girls(1.3:1), and highest incidence was noticed in newborn period, comprising 50% of the total cases. 2. The common clinical manifestations, in order of frequency, were fever, lethargy, jandice, poor sucking and abdominal distension, and hyperbilirubionemia was the most common assocaited disease, followed by anemia and leukemia. 3. Clinical course revealed death in 6 patients(10.3%), discharge against advice in 7cases(21.1%) and complete recovery in the remaining 45 cases(77.6%). 4. Peripheral blood count showed leukocytosie in 40%, leukopenia in 12.1% and thrombocytopenia was seen in 45% of cases. 5. Gram staining of buffy coat smear showed bacteria in 34.5% and especially high ratio was noticed in newborn infants(48.3%). 6. Positive blood culture was seen in 39.7% with highest ratio of 45% in newborn infants. In positive blood culture group, toxic granules were noted in 32.8%, shift to left in 25.9%, hrombocytopenia in 18.9% and positive buffy coat smear in 15.5%. In summary, thrombocytopenia, toxic granules, shift to left were quite helpful in early diagnosis of sepsis. In addition to diagnostic value, examination of buffy coat smear could aid physician to select appropriate antibiotic regimen especially in sepsis of newborn period.




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