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Development of an IFN-γ ELISpot Assay to Assess Varicella-Zoster Virus-specific Cell-mediated Immunity Following Umbilical Cord Blood Transplantation
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Varicella-related musculoskeletal complications in children

Anil K Gupta1, Abdullah A Bonajmah

  • 1Ministry of Health, Division of Paediatric Orthopaedics, Al-Razi Orthopaedic Hospital, Shuwaikh, Kuwait. akguptaortho@hotmail.com

Journal of Pediatric Orthopedics. Part B
|March 17, 2011
PubMed

Insights

Children experiencing post-varicella musculoskeletal complications, including cellulitis and osteomyelitis, often present with pain. Staphylococcus aureus, including MRSA, can be a cause, highlighting a broader spectrum of varicella-related infections.

Area of Science:

  • Pediatric Infectious Diseases
  • Musculoskeletal Infections
  • Viral Complications

Background:

  • Varicella (chickenpox) can lead to serious musculoskeletal complications in children.
  • These complications may include cellulitis, pyomyositis, osteomyelitis, and gangrene.
  • Prompt recognition and intervention are crucial for managing these severe sequelae.

Purpose of the Study:

  • To describe the clinical features and management of children with post-varicella musculoskeletal complications.
  • To identify causative pathogens and outcomes in this pediatric population.
  • To highlight the potential role of Staphylococcus aureus, including MRSA, in these infections.

Main Methods:

  • Retrospective case series of eight children treated between 2001 and 2009.
  • Review of clinical presentations, interventions, and microbiological data.
  • Analysis of outcomes, including morbidity associated with coagulopathy.

Main Results:

  • Common complications included cellulitis, pyomyositis, osteomyelitis, and gangrene, with pain as the most frequent presentation.
  • Average time from varicella infection to complication was 8.8 days.
  • Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA), was identified in pus cultures in two children.
  • Surgical interventions were frequently required, including drainage and, in one case, amputation.

Conclusions:

  • Post-varicella musculoskeletal infections represent a significant concern in pediatric care.
  • The spectrum of causative agents may include Staphylococcus aureus, necessitating appropriate antibiotic therapy and surgical management.
  • Varicella-related MRSA osteomyelitis indicates a potential expansion of infection patterns.

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