Hye Heon Hwang | 3 Articles |
Background
: Aseptic meningits is caused, for the most part, from viruses. Reports say that over 85% of its cause is from enterovirus and some of the rest from arbovirus, mumpsvirus, herpes simplexvirus, etc. Due to well-developed antibiotics, most recently, the proportion of aseptic meningitis to all meningitis has showed a rise trend, so that high contrat rate still has been proved epidemic in accrdence with causative viruses. Thereupon, we experienced 120 cases diagnosed aseptic meningitis among the patients who were hospitalized at the pediatric deparment, Jeong Eup Hospital, Asan Foundation, Jeon Ra Peuk Do in the middle of 1993, so we report the clinical observation and the literature on the subject. Methods : While working as the pediatric chief physician, We wrote examination reports and medical affairs records about the 120 cases diagnosed aseptic meningitis based on clinical findings and negative fidings on CSF Gram & AFB stain & culture with sensitive test among the patients hospitalized numerously in this area. Age and sex distribution, attack frequency in date, duration between onset of symptom and admission, duration of fever and admission, laboratory findings, clinical prognosis, and therapeutic result were analized based on the above mentioned examination reports and medical affairs records. Results : Aseptic meningitis in this area broke out numerously to be bimodel during the middle third and the last third of May and during the middle third and the last third of June. The rate of concurrent attack in family was 8 famillies among 112 families(7.1%). The rate of male to female was 1.7:1, so male was found to be vulnerable. Most common age was 1~5 years(46.7%h, main clinical ymtom was fever(98.3%), headache(47.5%), nausea(46.7%), pain on lower extremity(24.2%), pain on neck(22.5%), and skin rash(17.5%) in order. With peripheral blood laboratory findings, 52% of 120 cases had 10,000/mm³ or more of WBC which is called leukocytosis. 50% were found to keep 60% or more of neutrophils on percentage of WBC, 54.2% kept 40% or less of lympocytes, 74.2% showed 20 mm/hr or more of ESR, and 27.5% showed positive in CRP. In addition, with CSF, 44.2% showed 500/mm³ or more of WBC, to our suprise, 17.5% showed 1,000/mm³ or more of WBC, 90% of former example showed lymphocytosis. 15% showed 40mg/dl or more of protein which was increased level, only 2.5% showed 40mg/dl or less of sugar with which almost all were normal. The average duration between onset of initial symptom in which fever is primary symptom and admission was 3.8days. Becasuse the average duration of hospitalization was 13.5 days, we estimated that the average febile duration of aseptic meningitis is about 8 dyas and therapeutic duration is about 17 days. Conclusion : Almost all aseptic meningitis patients who had clinical symptom of fever, headache, vomiting, abdominal pain, etc and showed WBC(especially lymphocyte) increment on CSF, proved normal in sugar, but protein was increased with 15%, With fluid replacement and bed rest using symptomatic care, antipyretics and antibiotics to prevent secondary infection, the patients were cured completely without complication.
According to the many studies, acute drug intoxications are increasing in despite of scientific growth and changes of social status. The causative agents and clinical manifestations of drug intoxication becomes more complex because of the many drugs and the chemical substances were having developed recent years.
We analyzed 212 cases of acute drug intoxication by drug ingestion, visited to the emergency room of Jeong Eup General Hospital, for 1 yerar from Jan. 1992 to Dec. 1992. The results were as follows; 1. The ratio of drug intoxicated patients to total patients who visited emergency room was 2.2%. 2. Male was slightly more than female (1.14:1) and the age group of the sixth decade was the largest. 3. The monthly incidence was the highest in June(14.2%) and August(10.8%) with 34.0% in summer season(June to August). 4. The largest proportion of the time interval on arrival at emergency room and of presumed time of poisoning was night (8p.m-12p.m), each 26.0% and 23.6% respectively. 5. The duration of time from time of poisoning to arrival at emergency room was largely within 3 hrs. (77.3%), especially within 1hr. (46.2%). 6. The suicidally attempted poisonings were more frequent(79.7%) than accidental (14.6%) or therapeutic(5.7%). 7. The most common causative agent of intoxication was agricultural chemicals(64.6%) followed by medical drugs(24.1%) and other chemical agents(7.3%). 8. The chief complaints of the patients on admission were mental change(39.6%), nausea and vomiting(34.9%), abdominal pain(13.2%), but asymptomatic cases were as 7.1%. 9. The outcomes of the patients were recovery(42.0%), discharge against medical advice and transfer to other hospital(42.0%), and death(16.0%). 10. Herbicides showed highest fatality rate(38.0%) and then insecticides(20.8%) next.
This is the clinical studies of 90 cases of acute poisoning in pediatric age, visited the emergency room of Jeong Eup General Hospital, during the past 3 years from Jan., 1986 to Dec., 1988.
The following results were obtained. The incidence of acute poisoning among the emergency pediatric patients was 1.96%. The incidence was higher in boys than girls. The highest incidence was noted in the 1 to 3 year age group(28.9%), and followed by the 3 to 6 year age group (25.6%) and 13 to 15 year age group (23.3%). The peak incidence in a year was shown in April (16.7%), and August (14.4%) with prominence in spring and summer season. The accidental poisonings were frequent (67.8%) than suicidal or therapeutic purposes, which were 28.9% and 3.3% respectively. The accidental poisonings occurred most frequently from 4:00 P.M. to 8:00 P.M. during the day. The causative substances were 19 kinds. The agricultural chemicals were most common(45.6%) and the next common agents were rodenticide (13.3%), acetic acid (7.8%) fly & mosquitocides (4.4%), antifungal agent (4.4%) in order of frequency. The clinical manifestations at emergency room were nausea & vomiting (46.7%), altered consciousness (22.2%), irritability(17.8%), bronchial secretion(16.7%), miosis(12.2%) in order of frequency. 25 cases(27.8%) of the patients were found incidentally without symptoms. Outcome at emergency room was admission (55.6%), discharge at E.R. (30%), transfer (6.7%) hopeless, discharge (4.4%), exdeathed (3.3%) in order of frequency. The most common duration of admission was 2-3days (56%).
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