용인지역에서 관찰된 최근 유행한 소아 헤르페스목구멍염 입원환자의 임상양상

Abstract

Purpose: Herpangina is a febrile disorder due to enterovirus in children. Its manifestations could be changed according to its epidemic, but there had been no study for them in Korea. The purpose of this investigation is to know its clinical characteristics during recent epidemic, 2010. Methods: I collected the patient informations of herpangina retrospectively who had been diagnosed and admitted clinically at the Department of Pediatrics, Yongin Severance Hospital, Yongin, Korea from January 2010 to December 2012. I divided them three group by year. I investigated and compared their clinical findings. Results: There were 45 cases in 2010(group A;32 boys and 35 girls), 38 cases in 2011(group B; 21 boys and 17 girls), and 29 cases in 2012(group C;11 boys and 18 girls). The mean age was 2.0±1.4 years old and thirty- three cases(73.3%) were younger than 3 years old for group A. Herpangina cases were most frequent in June(28.3%) and clinical features were fever(97.8%), poor oral intake(91.1%), sore throat(46.7%), cough(46.7%), sputum(44.4%), rhinorrhea(40.0%), diarrhea(6.7%), and vomiting(15.6%) in group A. There were 18 cases of pneumonia(40.4%), 3 sinusitis(6.7%), and 2 bronchitis(4.4%) in group A. Elevated erythrocyte sedimentation rate(86.7%), serum c-reactive protein(68.9%), serum aspartate transaminase(46.7%), peripheral blood leukocyte count(26.7%), urinary ketone (27.3%) and decreased serum bicarbonate concentration(80.0%) were found in group A. Comparing the clinical findings of three groups, total fever duration of group A was longer than group B and C (3.6±2.0 days versus 2.3±1.9 days and 2.6±2.5 days; P=0.020). Decreased serum bicarbonate concentration (80% versus 55.1%; P=0.023) and urinary ketone(26.7% versus 18.4%; P=0.038) were more frequent and blood platelet counts(284,181.2±71,439.4/μL versus 249,551.7±61,289.5/μL; P=0.036) were higher in group A than that in group C. Pneumonia was more common in group A(40.0%) than group B(26.3%) and group C(24.1%). There was no significant difference among three groups regard-ing to age, sex and admission duration(4.1±2.0 days versus 3.7±1.9 days versus 3.6±1.1 days ; P=0.441). Conclusion: Although admission durations were not significantly different among them, epidemic herpangina patients showed more prolonged total fever duration, pneumonia, and dehydration. Its clinical features can be more serious during epidemic than endemic. Continuous monitoring and study for it should be carried on to catch up the up-to-date statues .