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Li-Min Huang

Publications and source records attributed to Li-Min Huang.

65 records · Page 4Linked to original sources
PubMed2002

Chromobacterium violaceum infection in children: a case of fatal septicemia with nasopharyngeal abscess and literature review.

This previously healthy 5-year-old boy initially presented with fever and purulent conjunctivitis. The course evolved rapidly into preseptal and facial cellulitis, nasopharyngeal abscess and sepsis. Chromobacterium violaceum was isolated from conjunctival exudate and blood cultures. He received intravenous cefazolin therapy for 2 days, followed by penicillin, oxacillin and netilmicin. However, no improvement was noted, and he died on the fifth days of illness.

Abscess↗
PubMed2002

A cephalometric study of facial growth in van der Woude syndrome.

OBJECTIVE: To test the hypothesis that maxillary growth and lower lip form in patients with van der Woude syndrome (VDW) is different from patients with non-syndromic cleft lip and palate. DESIGN AND SETTING: Retrospective, case-control study at a tertiary cleft center, Chang Gung Memorial Hospital, Taipei, Taiwan. PATIENTS AND PARTICIPANTS: Records of 53 patients with VDW, who presented for treatment during the years 1968 through 1998 were obtained. Twenty-three of 53 patients had received at least one lateral cephalogram during the course of their treatment. Of these 23, in 17 it was possible to find non-syndromic case controls with identical cleft type, sex, and method of cleft palate repair, with year of birth matching within 1 year of the corresponding VDW patient. For these 17 pairs of VDW and non-syndromic cleft controls, cephalogram acquisition dates were checked to see how well the corresponding pairs matched. A total of 43 pairs of cephalograms were deemed to be acceptably matched because the ages at acquisition differed by less than 15% of the VDW patient's age. MAIN OUTCOME MEASURES: Thirteen measurements were derived from the 11 standard lateral cephalometric landmarks recorded on each cephalogram. The data were classified into five groups according to age at time of cephalogram, and sets of paired non-syndromic cleft and VDW measurements were tested for differences using a Wilcoxon signed rank sum test in two ways, first including all cleft types and then including only those patients with complete bilateral cleft lip and palate. A longitudinal growth analysis considering the movement of the skeletal A and B points was performed on the patients with complete bilateral cleft lip and palate. RESULTS: For the osseous measurements, anteroposterior maxillary length as described by the anterior nasal spine (ANS)-posterior maxillary point distance was statistically significantly shorter in the VDW patients of age 13 years and older, by 5.3 mm. Maxillary height, as described by the nasion-ANS distance was shorter in the VDW patients, closely approaching statistical significance in the age range 7 through 11 years. The lip soft tissue measurements showed significantly greater protrusion over several age ranges in the VDW patients. The longitudinal growth analysis showed a significantly more inferior vertical position of the B point in the controls. CONCLUSIONS: This study demonstrates a few statistically significant differences in maxillary growth and lip conformation between VDW and matching controls. Small sample sizes for each age group hamper the ability to fully interpret or generalize the pattern of these differences.

Adolescent↗
PubMed2002

Clinical characteristics and management of acute suppurative thyroiditis in children.

BACKGROUND: Acute suppurative thyroiditis is an uncommon disease in children. This paper describes the clinical characteristics and management of children with acute suppurative thyroiditis treated during a 15-year period at National Taiwan University Hospital. PATIENTS AND METHODS: From 1985 to 2000, acute suppurative thyroiditis was diagnosed in 11 previously healthy children (6 boys, 5 girls) at the Department of Pediatrics. Their mean age at diagnosis was 6.4 +/- 4.4 years. Leukocyte count, acute-phase reactants, thyroid function, and thyroid autoantibodies were assessed. Samples were taken by thyroid needle aspiration for cytology study and pus culture. Underlying pyriform sinus fistula (PSF) was demonstrated by barium esophagogram. RESULTS: Leukocytosis was noted in six cases (55%) and acute-phase reactants were elevated in eight cases (73%). Neither thyroid autoantibodies nor thyroid dysfunction was detected in any of the patients. Barium esophagogram detected PSF in eight of 10 patients examined. Five (45%) patients had recurrent suppurative thyroiditis before surgery. Cytology and pus cultures were available for 10 patients. Polymorphonuclear cells were the main findings in the smear from thyroid aspirates. Twenty-two organisms were isolated from six patients (60%). Streptococcus species (45%) and anaerobic organisms (41%) were the most common pathogens isolated. Mixed infection was detected in five of six children who had a causative microorganism identified. The microorganisms were all sensitive to amoxicillin-clavulanate. CONCLUSION: PSF plays a role in the pathogenesis of acute suppurative thyroiditis in children. Streptococcus species are the most common pathogens in acute suppurative thyroiditis. Our results suggest that amoxicillin-clavulanate is the drug of choice for the treatment of this disease.

Acute Disease↗
PubMed2002

Streptococcal toxic shock syndrome manifesting as peritonitis in a child.

Streptococcal toxic shock syndrome (TSS) with the initial manifestation of peritonitis is rare. We report the case of a 5-year-old girl who presented with peritonitis and shock. Emergency laparotomy was performed but no perforated visceral organ was found. Acute respiratory distress syndrome, impaired renal function, and coagulopathy developed later. Group A beta-hemolytic Streptococcus (GAS) was isolated from the pleural effusion and the diagnosis of streptococcal TSS was made. This association highlights the need for thorough examination and close observation in the management of childhood peritonitis.

Child, Preschool↗
PubMed2002

Mycoplasma pneumoniae encephalitis in childhood.

Mycoplasma pneumoniae is an important etiologic agent of acute childhood encephalitis. We retrospectively reviewed 17 cases of M. pneumoniae encephalitis at the Pediatric Department of the National Taiwan University Hospital from April 1997 through March 2000. These cases were diagnosed as having positive immunoglobulin M antibodies (94%), a minimum 4-fold change of complement-fixation antibody titers (47%), or nested polymerase chain reaction. The ages of these patients ranged from 1.5 to 10.9 years (mean, 5.3 years) with a male-to-female ratio of 8:9. The clinical manifestations included fever (94%), altered consciousness (65%), seizure (41%), personality or behavior changes (29%), meningeal sign (24%), visual hallucination (24%), ataxia (12%), Guillain-Barré syndrome (6%), blurred vision (6%), and aphasia (6%). Respiratory symptoms and signs were found in 76% of the patients. Abnormal electroencephalogram and neuroimage were observed in all cases, while abnormal cerebrospinal fluid examination was noted in about one-third of the patients. Five (29%) patients required intensive care because of intractable seizure or respiratory failure. Fourteen (82%) patients recovered completely, but 3 (18%) had sequelae including epilepsy, hydrocephalus, and global neurologic deficits with brain stem dysfunction. In Taiwan, M. pneumoniae should be considered an etiologic pathogen of acute childhood encephalitis if fever and respiratory symptoms and signs are observed with or without abnormal cerebrospinal fluid findings. Supportive treatment is the basis of management.

Child↗
PubMed2002

Response to influenza vaccine in children with leukemia undergoing chemotherapy.

BACKGROUND AND PURPOSE: To assess the ability of children with acute lymphoblastic leukemia (ALL) to develop an antibody response after influenza vaccination. METHODS: A total of 65 children under 15 years old were studied, including 25 children with ALL undergoing chemotherapy, 30 with asthma in remission who were regularly followed at clinics, and 10 healthy children. The influenza vaccine contained antigens B/Yamanashi/166/98, A/New Caledonia/20/99 (H1N1), and A/Panama/2007/99 (H3N2). RESULTS: Children with ALL developed significant antibody titers to A/Panama /2007/ 99 antigen 4 weeks after the second immunization. Seroconversion rates after two doses of vaccine were 57.1 to 84.6% and seroresponse rates were between 24 and 60% in children with ALL. Compared to children with asthma in remission, who were regarded as immunocompetent individuals, the ALL children had less seroconversion and lower seroresponse rates to A/New Caledonia/20/99 (H1N1). The seroconversion and seroresponse rates to B/Yamanashi/166/98 and A/ Panama/2007/99(H3N2) antigens were comparable in asthmatic and leukemic children. On the other hand, the antibody response in children with ALL who received reinduction chemotherapy suggests that the therapy did not impair seroresponse rates. CONCLUSION: Our data suggest that the influenza vaccine is safe and effective in children with either ALL or asthma in Taiwan.

Antibodies, Viral↗
PubMedDate not supplied

Group B streptococcus infection in infancy: 21-year experience.

In this hospital-based review, clinical presentations associated with Group B streptococcus (GBS) infections in children occurring between January 1980 and March 2000 were analyzed. Among the 25 infants with invasive group B streptococcal infections, 9 (36%) were early onset diseases (EOD), 12 (48%) were late onset diseases (LOD), and 4 (16%) occurred beyond the third month of life. Eight of the nine (89%) EOD cases manifested during the first day of life and three (33%) were premature births. Common presentations in GBS infection were fever (75%), poor activity (25%), respiratory distress (25%), lethargy (20%), and irritability (20%). Seizure occurred in 31% of infants with meningitis. Pneumonia (66%) and case-fatality rate (33.3%) were significantly higher in EOD than in LOD. Meningitis was the major manifestation (77%) of LOD and had severe sequelae in 40% of cases. Eight strains were assayed for antibiotic sensitivity and they were all susceptible to penicillin, ampicillin, cefotaxime, and vancomycin. The susceptibilities to erythromycin and clindamycin were 62% and 75%, respectively. Most of the strains from blood or cerebrospinal fluid were type III.

Humans↗
PubMedDate not supplied

Geotrichum capitatum fungemia with skin lesions similar to varicella in a patient with acute lymphocytic leukemia.

Varicella-zoster virus (VZV) can cause increased morbidity and mortality in immunocompromised persons. Varicella lesions (macules, papules and vesicles) often appear first on the scalp, face or trunk. We report the case of a leukemic patient who developed multiple maculopapular rashes with central vesicles after chemotherapy. The skin lesions were first noted on the scalp, face and then trunk and extremities. These manifestations were similar to those caused by VZV. Both blood culture and skin vesicle fluid culture yielded Geotrichum capitatum, which is a thermotolerant, yeast-like fungus that forms on culture cream-colored wrinkled colonies. Serology study and throat swab culture for VZV were negative. This case raises the possibility that fungal infection can manifest chickenpox-like skin lesions in immunocompromised patients.

Chickenpox↗
PubMedDate not supplied

Bilateral lung abscesses due to pseudomonas aeruginosa infection after open heart surgery in an infant: report of one case.

Lung abscess is an infrequent but serious problem in children. Bilateral lung abscesses occur even less commonly. We experienced a case of bilateral Pseudomonas aeruginosa lung abscesses in a 2-month-old infant after open heart surgery for interrupted aortic arch. The clinical and radiographic manifestations, together with treatment responses, are described in the following case report.

Anti-Bacterial Agents↗
PubMedDate not supplied

Rubella seroprevalence among young women taipei county after routine measles, mumps and rubella immunization program.

To better target rubella immunization efforts by determining the age-specific rubella seroprevalence and the related factors for children in Taiwan after the 1986 national vaccine policy. A cross-sectional study was conducted for these girls aged 10 years (1994 cohorts), 13 years (1991 cohorts), 16 years (1988 cohorts), and 19 to approximately 22 years (1982-1985 cohorts), respectively, in 2004 in Taipei county. Participants were given a questionnaire detailing family income, education level, ethnicity of mother, number of siblings, and history of rubella infection. Possible predictors of rubella seropositivity and differences in seroprevalence were calculated by multivariate logistic regression analysis. A total of 826 cases were recruited. The geometric mean titer of rubella IgG antibody was 60.7 +/- 2.1 IU/ml. Rubella seropositive rates were 282/287 (98.3%) in children aged 10 years, 234/235 (99.6%) in aged 13 years, 179/185 (96.8%) in aged 16 years, and 110/119 (92. 4%) in aged 19-22 years. Older age, low maternal education level, and foreign mothers were correlated with seronegativity (p < 0.05). The MMR vaccine program has induced effectively the immunity against rubella. However, to eliminate congenital rubella syndrome, more effort should be taken for the vaccination of susceptible adolescents and young women.

Adolescent↗