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Group A streptococcal subdural empyema as a complication of varicella

Rolando Ulloa-Gutierrez1, Simon Dobson, John Forbes

  • 1Pediatric Infectious Diseases Division, Department of Pediatrics, British Columbia's Children's Hospital, and the University of British Columbia, Vancouver, British Columbia, Canada. rgut@cw.bc.ca <rgut@cw.bc.ca>

Pediatrics
|January 5, 2005
PubMed

Insights

Group A Streptococcus, a common cause of bacterial infections after chickenpox, led to a subdural empyema in an infant. Early recognition and varicella vaccination are crucial for preventing severe complications.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Neurology

Background:

  • Varicella (chickenpox) can lead to secondary invasive bacterial infections.
  • Group A beta-hemolytic Streptococcus and Staphylococcus aureus are the most frequent pathogens.
  • Prompt diagnosis and management are critical for favorable outcomes.

Observation:

  • A 3-month-old infant presented with fever, seizures, and lethargy on day 5 of varicella rash.
  • Intracranial hypertension and a subdural empyema were identified.
  • Streptococcus pyogenes was isolated from the subdural fluid.

Findings:

  • The infant developed a severe central nervous system complication, subdural empyema, secondary to varicella.
  • Streptococcus pyogenes was identified as the causative agent.
  • This case highlights a rare but serious bacterial complication of chickenpox.

Implications:

  • Central nervous system bacterial complications should be considered in infants and children with varicella exhibiting neurological symptoms.
  • Early recognition and intervention are vital for managing these severe infections.
  • Universal varicella vaccination is essential for preventing such potentially life-threatening complications.

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