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Complications of Varicella in Children


Authors: P. Kosina;  J. Krausová;  R. Kračmarová;  S. Plíšek
Authors‘ workplace: Klinika infekčních nemocí, Lékařská fakulta UK a Fakultní nemocnice, Hradec Králové přednosta MUDr. S. Plíšek, Ph. D.
Published in: Čes-slov Pediat 2009; 64 (7-8): 331-336.
Category: Original Papers

Overview

Introduction:
Varicella belongs to frequent diseases with relatively low rate of complications in immunocompetent children. Absolute numbers of complications which include particularly neurological, skin, metabolic and hematological ones, are not negligible. The most severe forms require a highly specialized costly therapy and may results in permanent consequences. A blanket or directed active immunization results in virtually complete elimination of severe course of varicella.

Methods and results:
The authors performed a retrospective analysis of 82 children with complications of varicella with evaluation of damage to individual organ systems in relation to individual age groups and development of permanent consequences. Twenty six children were admitted to hospital for various neurological complications, other most frequent causes were dehydration and bacterial superinfection. Five children underwent severe attacks of thrombocytopenia, three cases of varicella pneumonia represented important implications as well. Unclassified complications made 16 per cent of cases. The therapy took into consideration character of the disease and included parenteral nutrition, intravenous antibiotics and antivirotics, immunoglobulins, anticonvulsive drugs and in cases of synovitis nonsteroidal antirheumatics.

Conclusions:
In patients with varicella we would always consider possible development of complications. Adequate and timely therapy decreases the occurrence of permanent consequences to a minimum, but may not be completely excluded in cases of encephalitis and invasive bacterial superinfections.

Key words:
varicella complications, encephalitis, dehydration, bacterial superinfection, thrombocytopenia, live attenuated vaccine


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