, Yoon Jin Choi, Ji Yeon Byun, You Won Choi, Joo Young Roh, Hae Young Choi Nontuberculous mycobacterial infections, which are often acquired from environmental sources such as water and soil, exhibit a variety of cutaneous manifestations that frequently lead to misdiagnoses and delays in treatment. A 77-year-old woman presented with multiple skin lesions in a sporotricoid distribution on her right leg, which persisted despite standard antibiotic treatments. Based on the skin biopsy, revealing granulomatous inflammation with acid-fast bacilli, and PCR testing, a nontuberculous mycobacterial infection was diagnosed. Antimycobacterial drug combinations, including clarithromycin, isoniazid, and rifampicin for 4 months, complete the skin lesion's clearance. This case underscores the need for heightened suspicion and the use of appropriate diagnostic techniques, including tissue biopsies and molecular methods such as PCR.
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), is a type of human coronavirus that causes severe pneumonia, similar to SARS-CoV-1 and Middle East respiratory syndrome coronavirus. In Korea, the SARS-CoV-2 testing has started quickly from February 2020 to respond to the COVID-19 pandemic. In this article, I would like to introduce the characteristics of coronavirus and PCR test methods that play a large role in COVID-19 quarantine measures. Real-time reverse transcription (RT)-PCR is one of the molecular diagnostic method, and it detect SARS-CoV-2 RNA by amplifying SARS-CoV-2 specific
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, Yi Kyung Kim, Ji Eun Ban, Sejung Sohn, Young Mi Hong Adenovirus infection, which has been known to mimic Kawasaki disease (KD), is one of the most frequent conditions observed during differential diagnosis when considering KD. Accordingly, it is essential to being able to differentiate between these two diseases. Therefore, we performed multiplex reverse transcriptase- polymerase chain reaction and tissue-Doppler echocardiography to distinguish between adenovirus patients and KD patients.
A total of 113 adenoviral infection patients (female 48, male 65) diagnosed from January 2010 to June 2016 were evaluated. We divided adenoviral infection patients into two groups: group 1, which consisted of individuals diagnosed with KD according to the KD American Heart Association criteria (n=62, KD with adenovirus infection); and group 2, which comprised individuals only diagnosed with adenovirus infection (n=51). Laboratory data were obtained from each patient including N-terminal pro-brain natriuretic peptide. Echocardiographic measurements were compared between two groups. In addition, reverse transcriptase-polymerase chain reaction was performed using nasopharyngeal secretions to diagnose adenoviral infection.
Conjunctival injection, cervical lymphadenopathy, polymorphous skin rash, abnormalities of the lip or oral mucosa and abnormalities of extremities were significantly higher in group 1 than group 2. Moreover, group 1 had significantly higher C-reactive protein and alanine aminotransferase levels, as well as lower platelet counts and albumin levels than group 2. Coronary artery diameter was significantly greater in group 1 than group 2.
In patients with adenoviral infection with unexplained prolonged fever, echocardiography and C-reactive protein can be used to differentiate KD with adenoviral infection from adenoviral infection alone.
, Hee Won Kang, Young Min Youn, So-Yeon Shim, Eun Ae Park, Su Jin Cho 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.
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, Sae Han Kang, Byung Wook Jung, Hyeon Sik Oh, Min Ja Kim, Seung Hyeun Lee Differential diagnosis of invasive aspergillosis from other pulmonary fungal infections including mucormycosis is important because the treatment is pathogen-dependent. Clinically, invasive aspergillosis is often discriminated from other mold infections on the basis of typical histopathologic features in the biopsy specimen. However, biopsy alone is not always complete because different fungal species can display similar histopathologic features. Surrogate markers or molecular-based assays can be useful when the results of conventional diagnostic modalities are conflicting. Here, we present a case of invasive pulmonary aspergillosis histologically mimicking mucormycosis, which was confirmed by fungal polymerase chain reaction.
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, Duk Hee Kang, Gyu Bok Choi, Kyun Ill Yoon Patients undergoing maintenance hemodialysis(HD) potentially have an increased risk of exposure to viral hepatitis. The reported prevalence of antiHCV in hemodialysis patients varied widely form 7.6-54% according to dialysis center and there were there were many reports that showed the correlation between the prevalence of antiHCV and duration of HD or transfusion amount.
Fifty-four patients on regular hemodialysis at our hospital were evaluated for the presence of hepatitic C antibody(antiHCV) with the comparison of various parameters such as duration of HD, amount of transfusion, past history of hepatitis, serologic markers of hepatitis B and current liver function. AntiHCV using second-generation enzyme linked immunosorbant assay were found in six of 54HD patients(11.1%). Among six antiHCV(+) percent four patients were found to have HCV-RNA in their plasma detected by PCR. The percent of male patients were significantly higher in antiHCV(+) group(66.7 vs 31.3%, p<0.05). The positivity of antiHCV did not correlated with the duration of HD and amount of transfusion(p>0.05), but prevalence increased over 2 years (5.9% in 1991, 11.1% in 1993) and HBsAg prevalence remained unchanged(9.8% in 1991, 9.3% in 1993).
Therefore, regular follow-up of liver function test and use of separate machine for antiHCV positive patients may be needed to prevent the transmission of the hepatitis C virus during the hemodialysis process itself.
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