Compartment syndrome, disseminated intravascular coagulation, pneumonia, and acute renal failure due to varicella in a previously healthy child

摘要

Varicella infections are usually considered to be benign. Although very rare, infection of an immunocompetent patient by this virus may result in a severe illness. We describe a case of varicella infection in a previously healthy, immunocompetent 5-y-old boy, complicated with compartment syndrome, disseminated intravascular coagulation (DIC), pneumonia, and acute renal failure. He was treated successfully with aciclovir and intravenous immunoglobulins for the varicella infection, a fasciotomy for compartment syndrome, and fresh frozen plasma for DIC. Chickenpox is the primary infection caused by varicella zoster virus (VZV) and is manifested by a pap-ulovesicular rash and fever. Despite a decrease in varicella-related morbidity and mortality since the introduction of varicella immunization programs, chickenpox remains an almost universal early childhood disease worldwide. Varicella infections are usually considered to be benign, even though serious complications may occur. In an epidemiological study in Turkey by Koturoglu et al., an overall complication rate of 6.3 per 100,000 cases within 30 days after the onset of primary varicella was found [1]. Varicella complications have included skin/soft tissue, neurological, respiratory, gastrointestinal, hematologic, renal, hepatic, and musculoskeletal involvement [1,2].