[Serious complications of chickenpox: healthy children are at risk as well]

Area of Science:

• Pediatrics
• Infectious Diseases
• Neurology

Background:

• Varicella (chickenpox) is a common childhood illness, typically mild in immunocompetent individuals.
• Severe complications, though rare, can occur even in healthy children.
• Post-varicella neurological and systemic complications require prompt recognition and management.

Purpose of the Study:

• To highlight severe varicella-related complications in immunocompetent children.
• To emphasize the importance of considering varicella as a potential cause of serious illness, even months after primary infection.
• To advocate for specialist referral and antiviral therapy in severe cases.

Main Methods:

• Case series presentation of three immunocompetent children with severe varicella-related complications.
• Clinical case review including patient history, symptoms, diagnostic investigations, and treatment outcomes.
• Laboratory confirmation of varicella zoster virus in one case.

Main Results:

• Patient 1: Developed secondary bacterial pneumonia requiring Video Assisted Thoracoscopic Surgery (VATS) for debridement.
• Patient 2: Diagnosed with Ramsay Hunt syndrome (herpes zoster oticus) with facial paralysis and auricular lesions.
• Patient 3: Experienced ischemic stroke secondary to post-varicella arteriopathy, presenting with absence seizures.

Conclusions:

• Varicella complications can manifest severely in immunocompetent children, irrespective of the time elapsed since the primary infection.
• Conditions such as pneumonia, facial paralysis, and stroke should prompt consideration of varicella as an underlying cause.
• Prompt referral to medical specialists and consideration of antiviral therapy are essential for managing severe varicella-related complications.