PurposeBell’s palsy is characterized by sudden onset of unilateral facial weakness. The use of corticosteroids for childhood Bell’s palsy is controversial. This study aimed to identify clinical characteristics, etiology, and laboratory findings in childhood Bell’s palsy, and to evaluate the efficacy of corticosteroid treatment.MethodsWe conducted a retrospective analysis of children under 19 years of age treated for Bell’s palsy between January 2009 and June 2017, and followed up for over 1 month. Clinical characteristics, neuroimaging data, laboratory findings, treatments, and outcomes were reviewed. Patients with Bell’s palsy were divided into groups with (group 1) and without (group 2) corticosteroid treatment. Differences in onset age, sex, laterality, infection and vaccination history, degree of facial nerve palsy, and prognosis after treatment between the groups were analyzed.ResultsOne hundred patients were included. Mean age at presentation was 7.4±5.62 years. A total of 73 patients (73%) received corticosteroids with or without intravenous antiviral agents, and 27 (27%) received only supportive treatment. There was no significant difference in the severity, laboratory findings, or neuroimaging findings between the groups. Significant improvement was observed in 68 (93.2%) and 26 patients (96.3%) in groups 1 and 2, respectively; this rate was not significantly different between the groups (P=0.48).ConclusionChildhood Bell’s palsy showed good prognosis with or without corticosteroid treatment; there was no difference in prognosis between treated and untreated groups. Steroid therapy in childhood Bell’s palsy may not significantly improve outcomes.
Purpose: Magnetic resonance imaging (MRI) of the brain can provide valuable information about structural abnormalities in strabismus. The aim of this study was to evaluate the utility of MRI in this regard and to identify risk factors for abnormal MRI results in children with strabismus. Methods: A retrospective analysis of children <18 years of age presenting with strabismus, who underwent brain MRI at Pusan National University Hospital (Busan, Korea) between January 2012 and March 2017, was performed. Clinical characteristics, MRI results, and ophthalmologic findings were reviewed. Findings were classified as normal or abnormal according to MRI results. Additionally, patients were divided according to age to compare characteristics of infantile and childhood strabismus. Results: A total of 90 patients (47 [52.2%] male, 43 [47.8%] female; mean age, 2.19 ± 0.53 years) were enrolled. Of those, 64 (71.1%) presented with normal and 26 (28.9%) with abnormal MRI results. The age at presentation was lower and abnormal findings on fundus examination were more common in the abnormal MRI group ( P = .002 and P = .008, respectively). Among the patients, 46 (51.1%) had infantile strabismus and 44 (48.9%) had childhood strabismus. Global developmental delays, speech delays, and MRI abnormalities were more common in patients with infantile than in those with childhood strabismus. Ptosis and headaches were more common in patients with childhood strabismus ( P = .025, P = .025, respectively). Conclusion: Brain MRI was helpful for accurate diagnosis and treatment of strabismus in younger children, those with abnormal findings on fundus examination, and infants with developmental, especially speech, delays.
Streptococcus alactolyticus is grouped in S. bovis/S. equinus complex (SBSEC). SBSEC is found in the intestinal flora of humans and animals [1]. Certain bacteria include in SBSEC have caused human infection such as bacteremia or meningitis, but S. alactolyticus was identified rarely as pathogen in a few case. Especially, only one case was reported in neonatal sepsis. A case of fatal neonatal sepsis without meningitis due to S. alactolyticus has been reported, but the pathogen was identified in gastric fluid and samples from ear, trachea, and nasopharynx, not in blood and cerebrospinal fluid (CSF) [2]. Until now, there was no case report that was culture-proven S. alactolyticus as pathogen of neonatal bacterial meningitis. This is the first case presenting neonatal bacterial meningitis and sepsis caused by S. alactolyticus and treated successfully. A 28-day-old baby girl presented to our hospital with 2 day-fever history. She was born at 36 weeks and 2 days of gestational age, weighing 2,800 g by cesarean section. There were no prenatal and perinatal problems. After birth, she was healthy, fed well and had been cared-for at home. She got hepatitis B vaccination at birth. Examinations on other hospital revealed a fever, heart rate, and respiration rate of 38.7°C, 168 beats/min, and 44/min, respectively. There were Letter to the editor
Herpes simplex virus (HSV) is a common pathogen, that causes a broad spectrum of diseases, ranging from minor skin infections to severe encephalitis and widespread infections. Acute retinal necrosis (ARN), one of the most serious manifestations of HSV infection, is defined as a rapidly progressing necrotizing retinopathy that pre sents discrete areas of circumferential retinal necrosis, along with signs of uveitis, vitreitis, and retinal vasculitis. We encountered a case of a female infant, born at 33 weeks of gestation with a body weight at birth of 2,080 g, who had ARN and encepha lomalacia due to HSV infection. ARN associated with HSV infection should be sus pected when nonspecific retinal exudates are observed in neonates, especially preterm infants.
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