PurposeMeningitis is among the most common infections affecting the central nervous system. It can be difficult to determine the exact pathogen responsible for the infection and patients are often treated with empiric antibiotics. This study was conducted to identify the most common clinical characteristics of enteroviral meningitis in children and evaluate the diagnostic efficacy of reverse transcriptase-polymerase chain reaction (RT-PCR) for early detection of an enterovirus.MethodsWe analyzed the medical records of children admitted to Korea University Medical Center and diagnosed with meningitis on the basis of cerebrospinal fluid (CSF) analysis and RT-PCR from CSF and other samples from January 2010 to August 2013.ResultsA total of 333 patients were enrolled and classified into four groups based on diagnosis: enteroviral meningitis (n=110), bacterial meningitis (n=23), other viral meningitis (n=36), and unknown etiology (n=164). Patients with bacterial meningitis were younger than those in the other groups (P<0.001). Pleocytosis in CSF was similar across all groups. Of patients in the enteroviral meningitis group, 92.7% were diagnosed based on RT-PCR findings. Mean length of hospital stay for patients with enteroviral meningitis was 6.08 days, which was significantly shorter than that for patients with meningitis of bacterial etiology (19.73 days, P<0.001).ConclusionDiagnosis of enteroviral meningitis before viral culture results are available is possible using RT-PCR. Accurate diagnosis reduces the length of hospital stay and helps to avoid unnecessary empiric antibiotic treatment.

PurposeTo evaluate the practical applications of the diagnosis algorithms recommended by the American Academy of Pediatrics urinary tract infection (UTI) guideline.MethodsWe retrospectively reviewed the medical records of febrile UTI patients aged between 2 and 24 months. The patients were divided into 3 groups: group I (patients with positive urine culture and urinalysis findings), group II (those with positive urine culture but negative urinalysis findings), and group III (those with negative urine culture but positive urinalysis findings). Clinical, laboratory, and imaging results were analyzed and compared between the groups.ResultsA total of 300 children were enrolled. The serum C-reactive protein level was lower in children in group II than in those in groups I and III (P<0.05). Children in group I showed a higher frequency of hydronephrosis than those in groups II and III (P<0.05). However, the frequencies of acute pyelonephritis (APN), vesicoureteral reflux (VUR), renal scar, and UTI recurrence were not different between the groups. In group I, recurrence of UTI and presence of APN were associated with the incidence of VUR (recurrence vs. no recurrence: 40% vs.11.4%; APN vs. no APN: 23.3% vs. 9.2%; P<0.05). The incidence of VUR and APN was not related to the presence of hydronephrosis.ConclusionUTI in febrile children cannot be ruled out solely on the basis of positive urinalysis or urine culture findings. Recurrence of UTI and presence of APN may be reasonable indicators of the presence of VUR.

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Purpose: As the mobile internet spread, patients can access to health information via mobile applications. But this information must be a reliable for treatment. This study evaluated the quality of information of mobile applications that with atopic dermatitis. Methods: On April 2014, the 98 mobile applications that had been searched on three application markets using the keywords, 'atopic dermatitis' etc. were enrolled. Thirty-one applications with information about atopic dermatitis written in Korean were surveyed. The informational quality of each application was examined using DISCERN tool and we also examined authorship, price, number of downloads. And we analyzed relations between these factors and informational quality. Results: The mean score (± standard deviation) of overall rating of the publications of the 31 applications were 1.55 (± 0.888) points. The overall quality of the publication was 'low' in 80.6% of applications, 'moderate' in 16.1%, 'high' in 3.2% of the applications we evaluated. There were no significant differences between the score of price of applications in all questions. However the mean score of group of downloads 1,000 and more were 2.25 (± 1.035), significantly higher than group of downloads less than 1,000, 1.30 (± 0.703) (P= 0.043). Conclusion:The quality of mobile applications providing health information on atopic dermatitis needs significant improvement. Some guidelines and certifications of the mobile application are needed to provide health information about atopic dermatitis, association with experts.

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