Relationship between the Clinical Characteristics and Intervention Scores of Infants with Apparent Life-threatening Events

Choi, Hee Joung; Kim, Yeo Hyang

Eight patients had confirmed bacterial infections such as Enterobacter or Escherichia coli in urine in 3 patients, Staphylococcus or Streptococcus in blood in 3 patients, and Streptococcus in both blood and CSF in 2 patients. Although not statistically significant, the patients with confirmed bacterial infection showed higher incidence of fever than the other patients (25.0% vs. 4.8%, P = 0.176). Also, in laboratory test, they showed higher level of white blood cell (WBC) count (11,156.3 ± 5,066.3/μL vs. 9,699.0 ± 3,543.7/μL, P = 0.388) and C-reactive protein (CRP) (3.4 ± 5.1 mg/dL vs. 0.4 ± 0.5 mg/dL, P = 0.135) than the other patients. RV RT-PCR was performed for 11 patients, and several viruses were identified in 8 patients: respiratory syncytial virus in 3, human rhinovirus in 3, human parainfluenza virus in 3, and bocavirus in 1. Rotavirus antigen test showed positive result in 1 patient. Primary medical management for ALTE was supplemental oxygen and stimulation, each given to 18 patients (Table 3) . Eleven patients needed mechanical ventilator support with endotracheal intubation because of recurrent apnea in 9 patients, dyspnea in 1, and a CPR situation in 1. The median duration of ventilator care was 2.0 days (range, 1-25 days). Seventeen patients were treated with parenteral antibiotics for a suspected bacterial infection, including culture-confirmed bacterial infection. Infections were suspected to be pneumonia with respiratory symptoms in 11, sepsis with fever or shock in 4, and urinary tract infections with pyuria in 2. Two patients required CPR because of bradycardia and hypotension during the initial ALTE, but recovered.