소아의 아데노바이러스와 A군 연쇄구균 인두염의 임상적 특징의 비교 = A Comparison of Clinical Characteristics between Adenoviral and Group A Streptococcal Pharyngitis in Children

국문 초록 (Abstract)

목적: 본 연구는 아데노바이러스와 A군 연쇄구균에 의한 인두염에서 임상적 특징과 검사 소견의 차이를 비교하였다.
방법: 2011년 1월부터 2013년 7월까지 열성 호흡기질환으로 입원한 환자 중 아데노바이러스 감염 환자와2006년 8월부터 2013년 7월까지 성홍열의 증상으로 내원하여 A군 연쇄구균 인두염으로 진단된 환자를 대상으로 의무 기록을 후향적으로 분석하였다.
결과: 179명(AV1군)이 아데노바이러스 인두염으로진단되었고, 이 중 37명(AV2군)이 아데노바이러스 단독감염이었다. 26명(GAS군)의 환자가 성홍열로 진단되었다. 아데노바이러스 감염(AV2군)은 GAS군에 비하여 더어린 연령에서 발병하였다(2.8±2.1세 vs. 5.4±1.8세,P =0.000). 총 발열 기간과 입원 기간은 AV2군에서 더길었다(각각 6.3±2.6일 vs. 3.3±1.9일, P =0.000; 4.1±1.2일 vs. 1.9±1.8일, P =0.000). 백혈구 수는 AV2군에서 높았다(11,449±5,680/mm3 vs. 6,722±6,941/mm3,P =0.000). CRP는 AV2군과 GAS군에서 유의한 차이가없었다(3.8±3.2 mg/dL vs. 5.2±5.1 mg/dL, P =0.368).
항생제 사용 비율은 두 군에서 차이가 없었다(91.9% vs.
100%, P =0.261).
결론: 임상적 특징과 검사 소견에서 염증의 척도는 아데노바이러스와 A군 연쇄구균에 의한 인두염에서 유사하였다. 백혈구 및 CRP의 상승이 동반된 인두염 환자에서감별을 위해 조기에 호흡기 바이러스와 세균 검사를 시행하는 것이 필요하다.

다국어 초록 (Multilingual Abstract)

Purpose: To compare the clinical characteristics and laboratory finding between adenoviral and group A streptococcal(GAS) pharyngitis.
Methods: A retrospective review of medical records was performed in the patients with adenovirus infection among thosewho were admitted for febrile respiratory disease from January 2011 to July 2013 and GAS pharyngitis among those whovisited for symptoms of scarlet fever from August 2006 to July 2013.
Results: 179 patients (AV1 group) were diagnosed with adenoviral pharyngitis and 37 (AV2 group) of these patients hadadenovirus single infection. 26 patients (GAS group) were diagnosed with scarlet fever. Adenoviral infection (AV2 group)developed in younger patients compared to GAS group (2.8±2.1 years vs. 5.4±1.8 years, P =0.000). Total durations offever and admission were longer in AV2 (6.3±2.6 days vs. 3.3±1.9 days, P =0.000; 4.1±1.2 days vs. 1.9±1.8 days, P =0.000,respectively). WBC counts were higher in AV2 (11,449±5,680 cells/mm2 vs. 6,722±6,941 cells/mm2, P =0.000). CRP wasnot significantly different between AV2 and GAS group (3.8±3.2 mg/dL vs. 5.2±5.1 mg/dL, P =0.368). No difference wasfound between two groups in the percentage of antibiotics use (91.9% vs. 100%, P =0.261).
Conclusion: Clinical characteristics and measures of inflammation in the laboratory findings were similar between adenoviraland GAS pharyngitis group. It is necessary to conduct the test for respiratory virus and bacteria in early stage todifferentiate in the pharyngitis patients with leukocytosis and elevation of CRP level.

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