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Cardiac tamponade and pleural effusion complicating varicella: a case report

Syed Asif Masood1, Ernest Kiel, Olugbenga Akingbola

  • 1Department of Pediatrics, Louisiana State University, Shreveport, LA 71103, USA. masoodsa@ihs.org

Pediatric Emergency Care
|November 20, 2008
PubMed

Insights

Varicella infection can rarely cause severe complications like cardiac tamponade and pleural empyema in infants. This case highlights the importance of recognizing and managing these uncommon, serious pediatric varicella complications.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Cardiology

Background:

  • Varicella (chickenpox) is typically a mild childhood illness.
  • Serious complications, though rare, can occur, particularly in high-risk groups.
  • Cardiac tamponade due to varicella-associated pericardial effusion is exceptionally infrequent.

Observation:

  • An 8-month-old infant developed cardiac tamponade due to purulent bacterial pericardial effusion following varicella infection.
  • The infant also experienced pleural empyema, another uncommon complication of varicella.
  • Management involved a pericardial window formation and thoracostomy drainage.

Findings:

  • This case highlights the potential for severe cardiac and pulmonary complications following varicella infection, even in infants.
  • Bacterial superinfection of pericardial effusion leading to cardiac tamponade is a critical, albeit rare, sequela.
  • Pleural empyema represents another serious, uncommon complication requiring surgical intervention.

Implications:

  • Clinicians should maintain a high index of suspicion for severe complications in infants presenting with varicella, especially with cardiac or respiratory symptoms.
  • Early recognition and aggressive management are vital for improving outcomes in varicella-related cardiac tamponade and empyema.
  • Further review of literature is needed to fully understand the incidence and management of varicella-associated pericarditis and its complications.

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