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PubMedDate not supplied

A case of purpura fulminans secondary to transient protein C deficiency as a complication of chickenpox infection.

Purpura fulminans is a rare but dramatic disease which occurs most commonly during or after an infection. It is characterized by extensive involvement of the skin and extremities and involvement of visceral organs. Purpura fulminans, when occurring after a viral infection such as varicella, is usually characterized by purpuric lesions involving the trunk, usually with sparing of the visceral organs. In this report we describe a child with purpura fulminans due to a transient protein C deficiency as a complication of chickenpox infection. A seven-year-old girl developed bruise-like lesions on her extremities on the fifth day after eruption of varicella exanthem. She had no previous history of bleeding tendency or thrombosis. Family history was also negative. On the seventh day of her illness she was admitted to Marmara University Hospital with widespread echymotic an partially crusted chickenpox lesions. CBC, urinalysis and blood chemistries were within normal limits. She had a prolonged aPT and apt with low serum fibrinogen and high D-dimers suggestive disseminated intravascular coagulation (DIC). Protein C activity was low. Punch skin biopsy was consistent with purpura fulminans. She was treated with heparin and fresh frozen plasma which helped her to recover clinically as well as hematologically. She was discharged with still low protein C activity that returned to normal by the next follow-up visit.

Anticoagulants↗
PubMed2002

Acute cerebellar ataxia associated with chickenpox.

A case of a child with acute cerebellar ataxia associated with chickenpox virus infection is described. Acute cerebellar ataxia associated with chickenpox is a well-recognised complication and the pertinent features of this condition are discussed.

Acute Disease↗
PubMed2003

Necrotizing fasciitis secondary to chickenpox infection in children.

BACKGROUND: Necrotizing fasciitis is an uncommon but serious complication of chickenpox infection in young children. Because many of these infections affect the musculoskeletal tissues, orthopedic surgeons are often the first caregivers to be involved in diagnosis and treatment. Our objective was to review the diagnostic features of necrotizing fasciitis and analyze treatment methods to control and eradicate the musculoskeletal infection. DESIGN: A review. SETTING: The Children's Hospital of Eastern Ontario, Ottawa, a major Canadian pediatric trauma and referral centre. PATIENTS: Five children who presented with necrotizing fasciitis secondary to chickenpox infection. INTERVENTION: Surgical debridement of the involved area of necrotizing fasciitis and intravenous antibiotic treatment with clindamycin and penicillin. MAIN OUTCOME MEASURES: Complications outcome. RESULTS: The average age of the 5 children at presentation was 3.8 years (range from 2.9-5.8 yr). The necrotizing fasciitis involved the lower extremity in 5 children, the upper extremity in 3, and the abdomen, chest, neck and back in 1 child each. One child presented with involvement of all 4 extremities. In 4 children, culture specimens grew group A beta-hemolytic Streptococcus. They all survived and all limbs were salvaged, although secondary closure and skin grafting were required. At an average follow-up of 1 year, each child had fully recovered with no loss of muscle function. CONCLUSIONS: Necrotizing fasciitis should be suspected in any child with a history of varicella infection and an increasing complaint of pain and swelling in an extremity or other body area associated with increasing fever, erythema, lethargy and irritability. Emergent surgical debridement and intensive antibiotic therapy are essential to prevent muscle necrosis, major limb dysfunction and death.

Chickenpox↗
PubMedDate not supplied

[Periodicity of chickenpox and epidemic parotitis].

The pattern of the dynamics of incidence of chickenpox and epidemic mumps in Leningrad for many years was studied. The application of mathematical methods of treatment of the incidence data revealed the main trends of the processes and the occurrence of three rhythms in each infection. The average values of the periods of these rhythms differ for chickenpox and epidemic mumps and are 11.0, 6.2, and 4.1 years and 8.2, 4.0, and 2.8 years, respectively. The study of the age incidence in comparison with the dynamics of the epidemic process for many years showed that periodicity of these infections could not be explained completely by variations of the herd immunity of the population.

Adolescent↗
PubMed1992

A double blind, placebo controlled trial of efficacy and safety of oral acyclovir (Zovirax) in the treatment of chickenpox in adults.

A double-blind placebo controlled trial of oral acyclovir in otherwise healthy immune competent young adults with chickenpox was conducted. One hundred males were recruited into the trial, fifty were randomised to receive acyclovir at a dose of 800 mg five times daily for 5 days and fifty to receive matching placebo. Acyclovir recipients experienced itching and required anti-pruritic therapy for a significantly shorter period of time (p less than 0.05); no significant effects of acyclovir therapy on overall rash progression were observed. In patients with a mild rash on entry the maximum daily temperature recorded was significantly lower in the acyclovir group as compared with placebo recipients on day 1 of therapy (p less than 0.01). Acyclovir was extremely well tolerated and no adverse events were reported. Studies with early oral acyclovir therapy in otherwise healthy children with chickenpox has demonstrated significant benefits, particularly in rash progression. It is postulated that the partial benefits shown in this study in adults reflect the high proportion of patients with mild disease and enrollment of the majority of patients more than 24 hours after the rash onset.

Acyclovir↗
PubMed2004

Outbreak of chickenpox in a Scottish prison.

An outbreak of chickenpox occurred in a Scottish prison in April 2003. Three clinical cases (one virologically confirmed) were identified, two prisoners and one staff member. All were male and aged between 30 and 45 years. A further six possible cases were identified. The source of the outbreak was likely to have been a prisoner's child who visited the prison with a chickenpox rash. The outbreak was point source in nature, and no secondary spread of infection occurred within the prison despite the crowded conditions, possibly reflecting high levels of natural immunity. The outbreak serves as a reminder of the prison environment and the vulnerability of the prison population to infectious disease, both because of the prison environment and the clinical characteristics of the prison population.

Adult↗
PubMed1979

[The prevention of chickenpox in high risk children. Comparison of the effectiveness of specific immunoglobulins and of defibrinated convalescent plasma. 414 cases (author's transl)].

Comparison between 157 children treated with defibrinated convalescent plasma and 257 children treated with specific immunoglobulins revealed the improved effectiveness of the latter treatment in the prevention of chickenpox. Specific Herpes Zoster-Chickenpox immunoglobulins are prepared by caprylic acid fractionation of convalescent plasma. The prevention obtained in more than 90% of cases would appear to be clinically and biologically total as shown by serological surveillance of certain children with particularly severe immune depression.

Chickenpox↗
PubMed1989

Experimental studies on the prevention and treatment of chickenpox and herpes zoster with measles vaccine.

In 151 chickenpox patients treated with live attenuated measles vaccine, the cure rate was 100%. In 145 cases of herpes zoster, the effective rate was 100% (completely cured in 91.7% and improved in 8.3%). In the treated group, the time needed for the subsidence of fever and skin rash and the duration of the disease were markedly shorter than those in the control group (P less than 0.01). It is particularly effective for alleviating pain, preventing and relieving postherpetic neuralgia in patients with zoster. The application of measles vaccine to the patients in the chickenpox incubation period might prevent the development of the disease, and decrease the incidence and death rate of varicella zoster virus infection in highly susceptible patients. The mechanism of its anti-viral action and production of interferon in the body is discussed.

Chickenpox↗
PubMed1989

Chickenpox in the elderly.

Chickenpox (varicella) is primarily a childhood disease. Few escape infection until adulthood. We report three cases of chickenpox infection in elderly patients. They all developed the illness in December 1985.

Aged↗
PubMed1987

Chickenpox in adult renal transplant recipients.

Five of 610 adults developed chickenpox between 35 days and 9.2 years after renal transplantation, and only one patient survived. All patients received prednisolone and azathioprine during the incubation period. Corticosteroid therapy was continued, but azathioprine was stopped after diagnosis. Four patients were treated with acyclovir, but three were given suboptimal doses. The patient who survived had been taking the lowest dose of azathioprine and was given the recommended dose of acyclovir. All patients who died developed disseminated intravascular coagulation, and at postmortem examination were found to have had cerebral haemorrhage. None of the patients treated with acyclovir had evidence of active varicella-zoster virus infection at post-mortem examination, but two had disseminated bacterial and fungal infections. Chickenpox follows a severe and often fatal course in adults with renal transplants. Prompt acyclovir therapy can be effective, provided an adequate dose is given. Attention should be directed towards prevention by the identification and immunisation of at risk patients prior to transplantation.

Acyclovir↗
PubMed1988

Chickenpox in Canada, 1924-87.

Because of the lack of an effective vaccine and the difficulty in implementing any effective control measures, physicians and public health practitioners have paid little attention to understanding the epidemiologic features of chickenpox. No data on the incidence rate in Canada are available for 1959-85. However, Ontario data suggest an overall decrease in the annual rate during the 1960s and a stable rate since the mid-1970s. High incidence rates are expected among children 5 to 9 years of age because of their susceptibility and their greater exposure in school. Low incidence rates among older age groups are expected, because most of these people have already been exposed to the virus. The disease is more serious among infants than among other children. The risk of death from chickenpox is also highest among infants. More patient-specific information and improved collection of incidence data are required to measure any impact from future control procedures, including the use of vaccines currently being developed.

Adolescent↗
PubMed1987

[Acute respiratory distress syndrome in chickenpox in 3 healthy adults].

Three adults previously in good health developed pulmonary oedema during chickenpox. Severe hypoxemia required mechanical ventilation. All patients recovered without extensive pulmonary sequela on the first month pulmonary functional test. The severity of adult chickenpox requires hospitalization for treatment with Acyclovir.

Acute Disease↗
PubMed1979

Actinic chickenpox. Light-distributed varicella eruption.

When areas of the skin which are normally covered become sunburnt just before chickenpox eruption, there occurs a marked intensification of the rash on the freshly burnt parts. This phenomenon is not widely known. Its history, published reports and our original observations on this 'actinic' chickenpox are presented, with comment on its pathogenesis.

Adult↗
PubMed1984

[Risk of chickenpox during pregnancy and the neonatal period].

A newborn fell ill from congenital chickenpox eight days after delivery, a chickenpox rash having been noted in the mother two days before delivery. Administration of zoster-hyperimmune serum to the mother at the onset of the rash and to the child immediately after birth had no demonstrable effect on the course of the disease. Autopsy, the baby having died on the eleventh day post-partum, revealed focal necrotizing pneumonia of all the lobes. Varicella-zoster virus was isolated from lung material. On the basis of present knowledge the risk of varicella infection in the fetus and neonate is 1-7 maternal cases per 10 000 pregnancies. Transplacental passage of the virus can occur at any time during pregnancy. A congenital varicella syndrome is very rare in the first two thirds of pregnancy, but bland infection of the fetus is also likely. Illness of the mother at the end of pregnancy leads to clinically manifest varicella in about a quarter of neonates. The death-rate of congenital varicella is up to 30% if the mother falls ill between the fourth day before and the second day after delivery. Neonatal varicella acquired post-partum takes a relatively mild course. The most important prophylactic measure, in addition to the administration of zoster-hyperimmune serum to the mother within three days of incubation, is to delay delivery past the critical period.

Adult↗
PubMed1983

Chickenpox pneumonia. A case report.

A case of severe chickenpox pneumonia in an adult is presented. Continuous positive airways pressure (CPAP) was applied, with good effect. The occurrence of pneumonia in chickenpox may convert this mild disease of childhood into a potentially fatal condition.

Adult↗
PubMed1983

[Cellular and humoral immunity indices in chickenpox, rubella, measles and epidemic parotitis in adults].

Immunity characteristics at the height of the infectious process and at the period of convalescence were studied in 170 adult patients, aged 18-45 years, with chickenpox, rubella measles and epidemic parotitis. In chickenpox, rubella and measles a significant decrease, more pronounced in a severe course of the disease, in the number of T- and B-lymphocytes was observed, the immunosuppressive effect being more pronounced in measles. During convalescence the number of T- and B-lymphocytes in patients with the above-mentioned diseases approached the normal level with the exception of measles patients; in these patients the number of T-lymphocytes remained significantly below the normal level, while the content of IgG was increased. In the isolated form of epidemic parotitis no essential changes in immunity characteristics were detected, while in the disseminated forms, especially in those cases when the disease took a severe course, the tendency towards a decrease in the number of T-cells and a significant decrease in the levels of B-lymphocytes and IgG were observed. Prednisolone therapy used in such cases, though giving a good anti-inflammatory effect in parotitic orchitis, produced no immunosuppressive effect.

Adolescent↗
PubMed1994

[Fatal chickenpox infection in a newborn infant].

A fatal disseminated varicella zoster infection was diagnosed in a newborn boy. The mother had contracted chickenpox 1 day before delivery. Infants whose mothers suffer from chickenpox between 5 days before and 2 days after delivery, should receive varicella zoster immunoglobulin immediately post partum. If clinical symptoms still occur, aciclovir should be administered.

Chickenpox↗