To compare the epidemiology, clinical presentation, laboratory findings, seasonality and hospital course of enteroviral meningitis (EM) and non-enteroviral meningitis (NEM) cases in infants under 3 months of age.

A retrospective chart review was performed of infants under 3 months of age or less with viral meningitis admitted to Ewha Womans University Mokdong Hospital between January 2010 and December 2016.

EM patients were more likely to have siblings compared with NEM. Most of EM was diagnosed during the summer season. Almost 80% of EM was diagnosed between July and September. Fever lasted longer in EM patients compared to NEM. White blood cell count (WBC) from the cerebrospinal fluid was higher in EM patients compared with NEM patients. WBC in blood were lower in EM patients compared with NEM patients. C-reactive protein was lower in EM patients compared with NEM patients. Most of the patients were initially started on antibiotics therapy to rule out bacterial meningitis. EM patients received shorter duration of antibiotic treatment compared with NEM patients.

This study was conducted to augment the understanding of the incidence, epidemiology, transmission in infants, clinical presentation, laboratory findings, seasonality and hospital courses of enteroviral meningitis compared to NEM. Early recognition, rapid diagnosis and proper clinical management can reduce duration of antibiotic treatment.

The purpose of this study was to investigate the relationship of cord blood levels of soluble fms-like tyrosine kinase 1 (sFlt-1), placental growth factor (PlGF), and vascular endothelial growth factor (VEGF) in preterm infants with maternal preeclampsia.

Thirty six preterm infants born at Ewha Womans University Mokdong Hospital from January 2006 to August 2006 were studied after prior parental consent at mid-pregnancy. sFlt-1, PlGF, and VEGF levels in the cord blood of preterm neonate, with or without maternal preeclampsia, were measured using enzyme-linked immunosorbent assay.

There was no difference in sFlt-1 between infants with and without maternal preeclampsia. Infants with maternal preeclampsia had significantly lower PlGF levels (P=0.035) and higher sFlt-1/PlGF ratio (P=0.080) with borderline significance. Cord blood VEGF levels were not related to maternal preeclampsia. Infants with maternal preeclampsia had lower birth weight (P=0.030), lower neonatal platelet count without statistical significance (P=0.064) and more likely to be small for gestational age (P=0.057). Neonatal platelet count was significantly correlated with cord blood PlGF levels (r=0.674, P=0.032).

Increased sFlt-1/PlGF ratio and decreased PlGF may not only be related to the pathophysiology of maternal preeclampsia but also affect the neonatal platelet count and birth weight.

Acute disseminated encephalomyelitis(ADEM) is an acute demyelinating autoimmune inflammatory disease of the central nervous system which develops after infection of vaccination. It may be fatal, and produce a permanent residual static disability or fully recover. We retrospectively studied 14 cases to investigate the clinical findings and outcome of ADEM.

14cases of ADEM diagnosed at Ewha Womans University Mokdong Hospital from 1998 to 2003 were retrospectively reviewed.

The age of onset was 5 years±7.8 months and no seasonal clustering was found. The time of onset of symptoms was between 3 to 30 days. The preceding events were nonspecific upper respiratory infections in 9 cases, aseptic meningitis in 4 cases, and gastroenteritis in one case. The initial symptoms were seizure, altered consciousness, hemiparesis, fever, headache, and vomiting. Brain MRI showed multifocal high signal intensity lesions on T2 weighted image mainly in the cerebral whith matter, basal ganglia and periventricular white matter. EEG was performed in some cases and showed generalized or focal slow waves and only one case showed focal spikes. Patients were treated with IV globulin and methylprednisolone and the symptoms improved within 3-7 days after treatment. All patients were followed up for more than 2 months and most of them fully recovered except two.

ADEM presents in various clinical manifestations depending on its involvement of the brain lesions. Most cases recovered fully but in some cases, residual permanent neurologic sequelae remained.

Sepsis and its associated complication of disseminated intravascular coagulation (DIC) are considered to be a major cause of morbidity and mortality in the newborn infants. Antithrombin(AT) is a single chain glycoprotein in plasma and belongs to the family of the serpins. It is an important anticoagulant protein acting as a heparin cofactor. However, it's effects and action in preterm infants are not clearly defined. The objective of this study was to determine whether AT III was effective in treatment of DIC in the premature infants.

We studied 52 preterm infants with clinical and laboratory diagnosis of DIC from November 1998 to October 1999. We examined the AT III, platelet, prothrombin time(PT), activated partial thromboplastin time(aPTT), fibrinogen, fibrinogen degradation product(FDP), and D-dimer before and after the treatment with AT III.

1) AT III concentrates were administerd for a mean of 3.6 days. Plasma AT III concetrations were elevated significantly(p<0.001) in all cases to a mean level of 134.5%.

2) Hematologic data(PT, aPTT, Fibrinogen, FDP) was significantly improved in definitive DIC group after AT III treatment(p<0.05).

3) The incidence of complications of DIC patients were slightly higher in definitive DIC group than in suspected DIC group, but there was no statistically significant difference. And AT III concentrate were well tolerated in all patients.

This data suggested that AT III therapy was effective to improve the clinical and laboratory findings without significant side effects in the premature infants with DIC.