Complicated varicella zoster infection in 8 paediatric patients and review of literature

Singapore Med J. 1998 Mar;39(3):115-20.

Abstract

Background: This is a study of complicated varicella zoster infection in paediatric patients.

Aim: To find out the number of patients with such complications, the types of complications and their outcome.

Method: This involved a retrospective review of the case records of 8 patients who presented to our unit over a 12-month period (Jan-Dec 96). All patients were previously well without any underlying immunodeficiency. Varicella zoster (VZ) infection was confirmed by VZ immunofluorescence from vesicular fluid.

Results: CMS complications accounted for 6 of the 8 cases. Of these, 3 presented with encephalitis, 2 with cerebella ataxia and 1 with aseptic meningitis and cerebella ataxia. Of the non-CNS cases, 1 presented with glomerulonephritis with superimposed staphylococcus infection of skin ulcers; the other had disseminated VZ infection with haemorrhagic vesicles, hepatitis, ileus with mesenteric adenitis and disseminated intravascular coagulation.

Outcome: The patient with disseminated VZ infection and multiple organ involvement died 5 days after a stormy course. One patient with encephalitis who had status epilepticus for 2 hours had behavioural problems and poor memory. The remaining 6 patients had no sequelae.

Conclusion: VZ infection usually a minor illness, can result in serious life-threatening complications in previously healthy patients.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Cerebellar Ataxia / virology
  • Chickenpox / complications*
  • Chickenpox / virology
  • Child
  • Child Behavior Disorders / virology
  • Child, Preschool
  • Disseminated Intravascular Coagulation / virology
  • Encephalitis, Viral / virology
  • Fatal Outcome
  • Female
  • Fluorescent Antibody Technique
  • Glomerulonephritis / virology
  • Hepatitis, Viral, Human / virology
  • Herpesvirus 3, Human / isolation & purification
  • Humans
  • Infant
  • Intestinal Obstruction / virology
  • Lymphadenitis / virology
  • Male
  • Memory Disorders / virology
  • Meningitis, Aseptic / virology
  • Retrospective Studies
  • Skin Ulcer / microbiology
  • Staphylococcal Infections / complications
  • Status Epilepticus / virology