지난 13년간(2000-2012) 용인지역에서 관찰된 소아 수족구병 입원 환자의 임상 양상

Abstract

Purpose: Hand, foot and mouth disease(HFMD) has become well-known due to its neurological complication and death since 2009 in Korea. There were only short-term researches for its clinical features . The purpose of this investigation is to know its epidemic and clinical manifestations observed for a long-term period. Methods: I collected the patient informations of HFMD retrospectively who had been diagnosed and admitted clinically at the Department of Pediatrics, Yongin Severance Hospital, Yongin, Korea from January 2000 to December 2012. I investigated their epidemic and clinical characteristics. Results: There were 59 cases for 13 years(34 boys and 25 girls). The mean age was 2.1±1.6 years old. Forty-three cases(72.9%) were younger than 3 years old. The peak month was May(28.8%). There were three cycles with 4-5 years interval. The annual patient number was increasing (r=0.690). Its clinical manifestations were poor oral intake(96.6%), fever(78.0%), sore throat(66.1%), cough(39.0%), rhinorrhea(39.0%), sputum(37.3%). There were 17 cases of pneumonia(28.8%), 3 bronchiolitis(5.1%), 4 gastroenteritis(6.8%), 3 sinusitis(5.1%). Serum aspartate transaminase , blood glucose, blood and urinary leukocyte count were elevated in 22 cases(37.3%), 12 cases(20.3%), 13 cases(22.0%) and 24 cases(43.6%) respectively. Serum bicarbonate concentration was decreased in 36 cases(61.0%). Urinary ketone was found in 12 cases(40.0%). Duration of admission was 3.4±1.4 days and only two patients were admitted for more than 7 days. The peak incidence month per cycle was changed from May during two cycles(2000-2005, 66.7%; 2006-2008, 40.0%) to July during last cycle(2009-2012, 34.4%). When comparing the demographic and clinical characteristics of last cycle and previous cycles, there was no significant difference. Conclusion: A significant proportion of HFMD patients had systemic manifestations, so physicians should be cautioned for its various organ involvement. Although no definite clinical change was found despite of the change for peak incidence month between the last and previous cycle(s), continuous monitoring and multi-center studies for it should be carried on to confirm this finding.