Complications of varicella in children: Emphasis on skin and central nervous system disorders

H. W. Tseng, Ching-Chuan Liu, Shih-Min Wang, Yao-jong Yang, Y. S. Huang

研究成果: Article

21 引文 (Scopus)

摘要

A review of medical records at a tertiary hospital in southern Taiwan from June 1988 through May 1998 identified 136 children who had been hospitalized for varicella-related complications. Of the children, 83% (113/136) were healthy before the onset of varicella and 17% (23/136) had underlying illnesses, The mean age was 4.7 years (ranged from 1 day to 18 years) with a male predominance (1.7:1). The mean hospital stay was 5.5 days (ranged from 1 to 22 days). Secondary bacterial skin or soft tissue infections were the most common complications (44%), followed by central nervous system (CNS) involvement (23%), pneumonia (18%), thrombocytopenia (12%), and liver function impairment (10%). Among the 60 patients with secondary bacterial cutaneous infection, 16 (27%) had positive isolates, including 12 isolates of Staphylococcus aureus and four Streptococcus pyogenes. Age above 8 years was significantly associated with the development of varicella-associated CNS complications (p = 0.019). Of the 23 immunocompromised hosts, the most common underlying conditions were hematological diseases (11 patients, 48%), followed by neonatal varicella (7 patients, 30%) and chronic illness with steroid treatment (5 patients, 22%). All of the subjects in this study had a favorable outcome except for three lethal cases, resulting in a case-fatality rate of 2.2%. The cause of death was S. aureus septicemia in one patient, streptococcal toxic shock syndrome in one patient, and encephalitis with brain herniation in one patient. Our results demonstrate that varicella continues to be a serious disease that occasionally results in life-threatening complications in healthy and immunocompromised children. Routine immunization of all healthy children against varicella is recommended.

原文English
頁(從 - 到)248-252
頁數5
期刊Journal of Microbiology, Immunology and Infection
33
發行號4
出版狀態Published - 2000 十二月 1

指紋

Chickenpox
Central Nervous System Diseases
Skin
Staphylococcus aureus
Central Nervous System
Soft Tissue Infections
Hematologic Diseases
Streptococcus pyogenes
Immunocompromised Host
Encephalitis
Septic Shock
Taiwan
Bacterial Infections
Tertiary Care Centers
Thrombocytopenia
Medical Records
Cause of Death
Immunization
Length of Stay
Sepsis

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Immunology and Microbiology(all)
  • Microbiology (medical)
  • Infectious Diseases

引用此文

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title = "Complications of varicella in children: Emphasis on skin and central nervous system disorders",
abstract = "A review of medical records at a tertiary hospital in southern Taiwan from June 1988 through May 1998 identified 136 children who had been hospitalized for varicella-related complications. Of the children, 83{\%} (113/136) were healthy before the onset of varicella and 17{\%} (23/136) had underlying illnesses, The mean age was 4.7 years (ranged from 1 day to 18 years) with a male predominance (1.7:1). The mean hospital stay was 5.5 days (ranged from 1 to 22 days). Secondary bacterial skin or soft tissue infections were the most common complications (44{\%}), followed by central nervous system (CNS) involvement (23{\%}), pneumonia (18{\%}), thrombocytopenia (12{\%}), and liver function impairment (10{\%}). Among the 60 patients with secondary bacterial cutaneous infection, 16 (27{\%}) had positive isolates, including 12 isolates of Staphylococcus aureus and four Streptococcus pyogenes. Age above 8 years was significantly associated with the development of varicella-associated CNS complications (p = 0.019). Of the 23 immunocompromised hosts, the most common underlying conditions were hematological diseases (11 patients, 48{\%}), followed by neonatal varicella (7 patients, 30{\%}) and chronic illness with steroid treatment (5 patients, 22{\%}). All of the subjects in this study had a favorable outcome except for three lethal cases, resulting in a case-fatality rate of 2.2{\%}. The cause of death was S. aureus septicemia in one patient, streptococcal toxic shock syndrome in one patient, and encephalitis with brain herniation in one patient. Our results demonstrate that varicella continues to be a serious disease that occasionally results in life-threatening complications in healthy and immunocompromised children. Routine immunization of all healthy children against varicella is recommended.",
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AU - Liu, Ching-Chuan

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AU - Yang, Yao-jong

AU - Huang, Y. S.

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N2 - A review of medical records at a tertiary hospital in southern Taiwan from June 1988 through May 1998 identified 136 children who had been hospitalized for varicella-related complications. Of the children, 83% (113/136) were healthy before the onset of varicella and 17% (23/136) had underlying illnesses, The mean age was 4.7 years (ranged from 1 day to 18 years) with a male predominance (1.7:1). The mean hospital stay was 5.5 days (ranged from 1 to 22 days). Secondary bacterial skin or soft tissue infections were the most common complications (44%), followed by central nervous system (CNS) involvement (23%), pneumonia (18%), thrombocytopenia (12%), and liver function impairment (10%). Among the 60 patients with secondary bacterial cutaneous infection, 16 (27%) had positive isolates, including 12 isolates of Staphylococcus aureus and four Streptococcus pyogenes. Age above 8 years was significantly associated with the development of varicella-associated CNS complications (p = 0.019). Of the 23 immunocompromised hosts, the most common underlying conditions were hematological diseases (11 patients, 48%), followed by neonatal varicella (7 patients, 30%) and chronic illness with steroid treatment (5 patients, 22%). All of the subjects in this study had a favorable outcome except for three lethal cases, resulting in a case-fatality rate of 2.2%. The cause of death was S. aureus septicemia in one patient, streptococcal toxic shock syndrome in one patient, and encephalitis with brain herniation in one patient. Our results demonstrate that varicella continues to be a serious disease that occasionally results in life-threatening complications in healthy and immunocompromised children. Routine immunization of all healthy children against varicella is recommended.

AB - A review of medical records at a tertiary hospital in southern Taiwan from June 1988 through May 1998 identified 136 children who had been hospitalized for varicella-related complications. Of the children, 83% (113/136) were healthy before the onset of varicella and 17% (23/136) had underlying illnesses, The mean age was 4.7 years (ranged from 1 day to 18 years) with a male predominance (1.7:1). The mean hospital stay was 5.5 days (ranged from 1 to 22 days). Secondary bacterial skin or soft tissue infections were the most common complications (44%), followed by central nervous system (CNS) involvement (23%), pneumonia (18%), thrombocytopenia (12%), and liver function impairment (10%). Among the 60 patients with secondary bacterial cutaneous infection, 16 (27%) had positive isolates, including 12 isolates of Staphylococcus aureus and four Streptococcus pyogenes. Age above 8 years was significantly associated with the development of varicella-associated CNS complications (p = 0.019). Of the 23 immunocompromised hosts, the most common underlying conditions were hematological diseases (11 patients, 48%), followed by neonatal varicella (7 patients, 30%) and chronic illness with steroid treatment (5 patients, 22%). All of the subjects in this study had a favorable outcome except for three lethal cases, resulting in a case-fatality rate of 2.2%. The cause of death was S. aureus septicemia in one patient, streptococcal toxic shock syndrome in one patient, and encephalitis with brain herniation in one patient. Our results demonstrate that varicella continues to be a serious disease that occasionally results in life-threatening complications in healthy and immunocompromised children. Routine immunization of all healthy children against varicella is recommended.

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