- Infection
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Kawasaki Disease with Acute Respiratory Distress Syndrome after Intravenous Immunoglobulin Infusion
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Yu Hyeon Choi, Bong Jin Lee, June Dong Park, Seung Hyo Kim
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Korean J Crit Care Med. 2014;29(4):336-340. Published online November 30, 2014
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DOI: https://doi.org/10.4266/kjccm.2014.29.4.336
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Abstract
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- Kawasaki disease (KD) is an acute systemic vasculitis of unknown etiology. We report a case of KD with acute respiratory distress syndrome (ARDS) after intravenous immunoglobulin (IVIG) infusion. Lung manifestations associated with KD have previously been reported in the literature. Although IVIG infusion is an effective therapy for acute KD, there are some reported complications related to IVIG infusion: hypotension, aseptic meningitis, acute renal failure, hemolytic anemia, etc. The case of KD reported here was treated with IVIG and aspirin. A few days after recovery from KD, the patient developed fever and maculopapular rash. A diagnosis of relapse KD was made and retreated with IVIG infusion. However, the patient developed ARDS four days after the second IVIG infusion. The patient recovered from ARDS after nine days of ICU care, which included high frequency oscillation ventilation with inhaled nitric oxide, steroid treatment and other supportive care.
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Citations
Citations to this article as recorded by
- French national diagnostic and care protocol for Kawasaki disease
C. Galeotti, F. Bajolle, A. Belot, S. Biscardi, E. Bosdure, E. Bourrat, R. Cimaz, R. Darbon, P. Dusser, O. Fain, V. Hentgen, V. Lambert, A. Lefevre-Utile, C. Marsaud, U. Meinzer, L. Morin, M. Piram, O. Richer, J.-L. Stephan, D. Urbina, I. Kone-Paut La Revue de MĂ©decine Interne.2023; 44(7): 354. CrossRef
- Cardiology/Pediatric
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Effectiveness of Bradycardia as a Single Parameter in the Pediatric Acute Response System
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Yu Hyeon Choi, Hyeon Seung Lee, Bong Jin Lee, Dong In Suh, June Dong Park
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Korean J Crit Care Med. 2014;29(4):297-303. Published online November 30, 2014
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DOI: https://doi.org/10.4266/kjccm.2014.29.4.297
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- BACKGROUND
Various tools for the acute response system (ARS) predict and prevent acute deterioration in pediatric patients. However, detailed criteria have not been clarified. Thus we evaluated the effectiveness of bradycardia as a single parameter in pediatric ARS. METHODS This retrospective study included patients who had visited a tertiary care children's hospital from January 2012 to June 2013, in whom ARS was activated because of bradycardia. Patient's medical records were reviewed for clinical characteristics, cardiologic evaluations, and reversible causes that affect heart rate. RESULTS Of 271 cases, 261 (96%) had ARS activation by bradycardia alone with favorable outcomes. Evaluations and interventions were performed in 165 (64.5%) and 13 cases (6.6%) respectively. All patients in whom ARS was activated owing to bradycardia and another criteria underwent evaluation, unlike those with bradycardia alone (100.0% vs.
63.2%, p = 0.016). Electrocardiograms were evaluated in 233 (86%) cases: arrhythmias were due to borderline QT prolongation and atrioventricular block (1st and 2nd-degree) in 25 cases (9.2%). Bradycardia-related causes were reversible in 202 patients (74.5%). Specific causes were different in departments at admission. Patients admitted to the hemato-oncology department required ARS activation during the night (69.3%, p = 0.03), those to the endocrinology department required ARS activation because of medication (72.4%, p < 0.001), and those to the gastroenterology department had low body mass indexes (32%, p = 0.01). CONCLUSIONS Using bradycardia alone in pediatric ARS is not useful, because of its low specificity and poor predictive ability for deterioration. However, bradycardia can be applied to ARS concurrently with other parameters.
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Citations
Citations to this article as recorded by
- Effect of Diurnal Variation of Heart Rate and Respiratory Rate on Activation of Rapid Response System and Clinical Outcome in Hospitalized Children
Lia Kim, Kyoung Sung Yun, June Dong Park, Bongjin Lee Children.2023; 10(1): 167. CrossRef - Eleven years of experience in operating a pediatric rapid response system at a children’s hospital in South Korea
Yong Hyuk Jeon, Bongjin Lee, You Sun Kim, Won Jin Jang, June Dong Park Acute and Critical Care.2023; 38(4): 498. CrossRef - Pediatric triage modifications based on vital signs: a nationwide study
Bongjin Lee, June Dong Park, Young Ho Kwak, Do Kyun Kim Clinical and Experimental Emergency Medicine.2022; 9(3): 224. CrossRef
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Disseminated Neonatal Herpes Simplex Virus Infection
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Bongjin Lee, Jinsol Hwang, Yu Hyeon Choi, Young Joo Han, Young Hun Choi, June Dong Park
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Korean J Crit Care Med. 2013;28(4):331-335.
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DOI: https://doi.org/10.4266/kjccm.2013.28.4.331
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3,058
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- Disseminated neonatal herpes simplex virus (HSV) infection is one of the most severe neonatal infections, and can have devastating consequences without early proper treatment.
However, the administration of acyclovir can often be delayed because the symptoms and signs of HSV infection are non-specific and because HSV polymerase chain reaction (PCR) results may be negative early in the course of HSV infection. We report a case of disseminated neonatal HSV infection that was diagnosed by type 1 HSV PCR on day 8 of admission. Despite delayed administration of acyclovir, the patient was cured and subsequently discharged after 30 days of admission. Fortunately, this patient was treated successfully, but delayed administration of acyclovir has the potential to lead to significant problems. Considering the seriousness of neonatal HSV infection, empirical acyclovir therapy should be considered if HSV infection is suspected.
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Citations
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- A Case of Herpes Simplex Virus Type 2 Encephalitis of a Newborn Delivered by a Mother without Prenatal Screening
Eun Seob Lee, Joon Young Kim, Kon Hee Lee, Jung Won Lee, Yong Ju Lee, Yeon Joung Oh, Ji Seok Bang, Tae-Jung Sung Korean Journal of Perinatology.2014; 25(3): 195. CrossRef
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