Biomedical subjects

Ping-Ing Lee

Publications and source records attributed to Ping-Ing Lee.

25 records · Page 2Linked to original sources

PubMed2002

Study of an outbreak of Enterobacter cloacae sepsis in a neonatal intensive care unit: the application of epidemiologic chromosome profiling by pulsed-field gel electrophoresis.

OBJECTIVE: From October 1996 to March 1997, a cluster of 11 cases of neonatal sepsis caused by Enterobacter cloacae with similar antimicrobial susceptibility patterns occurred in a neonatal intensive care unit. This outbreak prompted an investigation. METHOD: Twelve isolates obtained from 6 neonatal patients who developed E cloacae sepsis during the outbreak were analyzed. Four E cloacae isolates from 2 preterm neonates without E cloacae infection on the same ward, and 1 isolate from the hands of a nurse, were also examined. No E cloacae were isolated from the environment. Bacterial DNA digested with XbaI or NotI was analyzed with pulsed-field gel electrophoresis. RESULT: Three distinct banding patterns were identified by pulsed-field gel electrophoresis. Of the 6 preterm infants with sepsis, strain I was identified in 1, strain II in 2, a mixed infection of strains I and II in 2, and strain III was found in only 1 infant. An isolate from the hands of a nurse was identified as strain II, as were the 4 isolates from the 2 preterm neonates without E cloacae infection. Thus, this outbreak of sepsis was caused by 2 genotypes of E cloacae. CONCLUSION: This study demonstrates that pulsed-field gel electrophoresis with restriction enzyme digestion is a valuable tool for genetic characterization of multidrug-resistant E cloacae strains during outbreaks.

Bacterial Typing Techniques↗

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

Mycobacterium kansasii infection presenting as cellulitis in a patient with systemic lupus erythematosus.

The prevalence of mycobacterial infection has increased in recent years, especially in patients immunocompromised due to autoimmune disease, malignancy and AIDS. Mycobacterium kansasii infection most commonly presents as tuberculosis-like pulmonary disease. We report the case of a 38-year-old woman with systemic lupus erythematosus (SLE) who developed cellulitis over the left lower leg and had poor response to antibiotics. Two months before this admission, she had sustained a small wound over the right pretibial area and had noticed erythematous swelling after swimming at the beach. Pathologic examination of biopsied tissue showed acid-fast bacilli, and culture yielded M. kansasii. The cellulitis improved gradually during treatment with antimycobacterial agents for 1 year. This case emphasizes the possibility that cutaneous M. kansasii infection may occur in an immunocompromised patient and that exposure to contaminated water is a possible source. With early diagnosis, the response to an antimycobacterial multidrug regimen is usually satisfactory.

Adult↗

PubMedDate not supplied

Reye's syndrome developing in an infant on treatment of Kawasaki syndrome.

Aspirin is commonly used as an anti-inflammatory therapy for Kawasaki syndrome. Early initiation with high dose aspirin (80 to > 100 mg/kg per day), followed by low-dose therapy at the afebrile stage, has been often used to reduce morbidity and mortality in coronary complications. We report a 10-month-old infant who was diagnosed with Kawasaki syndrome. Sudden onset of poor activity, poor appetite, lethargy, tachycardia, tachypnea, hepatomegaly, increased AST/ALT, coagulopathy and hyperammonemia developed 3 days after the high-dose aspirin therapy. His histopathological and ultrastructural findings from the liver biopsy were compatible with Reye's syndrome. He recovered completely, and there was no recurrence.

Anti-Inflammatory Agents, Non-Steroidal↗

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↗