Clinical Profile of Hospitalized Varicella Cases From Pediatric Emergency Consultations: A Retrospective Cohort Study
Hasnae El Haddadi1,2, Amal Hamami1, Anane Sara1,2
1Department of Pediatrics, Mohammed VI University Hospital, Oujda, MAR.
Insights
Varicella is usually mild in children but can cause severe complications, especially in those with risk factors. Vaccination could significantly decrease hospitalizations for this common childhood illness.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Varicella (chickenpox) is a common childhood infection, generally benign but with potential for fatal outcomes.
- Understanding its clinical and therapeutic profile in emergency settings is crucial for management.
- Assessing hospitalization and complication rates informs public health strategies.
Purpose of the Study:
- To describe the clinical and therapeutic characteristics of varicella in a pediatric emergency department.
- To determine the incidence of varicella hospitalizations and associated complications.
- To identify risk factors for severe varicella cases.
Main Methods:
- Retrospective descriptive cohort study over 12 months.
- Data collected from pediatric and pediatric emergency departments.
- Analysis of 120 varicella cases.
Main Results:
- Mean age of patients was 4.5 years; most common age range 4-6 years.
- Febrile rash was the primary reason for emergency consultation (65%).
- Hospitalized cases (17) were often in immunodeficient children (82%) with skin/soft tissue infections (47%) and neurological complications (23%).
Conclusions:
- Varicella is typically benign in children but complications necessitate hospitalization in those with comorbidities or risk factors.
- Intravenous acyclovir and antibiotics were common treatments for severe cases.
- Varicella vaccination could reduce future hospitalizations.
Background:
Varicella is a very common childhood infectious disease. It is generally benign, but it can lead to fatal complications. Our study aimed to describe the clinical and therapeutic profile of varicella based on consultations in the pediatric emergency department, to determine the incidence of hospitalized varicella cases in the pediatric department for complementary management, and to specify the incidence of varicella complications in hospitalized patients.
Materials And Methods:
We conducted a retrospective descriptive cohort study over 12 months. It took place in the pediatrics and pediatric emergency departments of the Mother-Child Hospital of the Mohammed VI University Hospital, Mohammed I University, in Oujda, Morocco.
Results:
We collected 120 cases of varicella. The mean age of patients was 4.5 years. The most common age range was 4-6 years (69%). Males predominated. The reason for consulting the pediatric emergency department was a febrile rash in 65% of cases. Treatment in pediatric emergencies was mostly symptomatic. Antibiotic treatment for superinfection of lesions was used in 11% of cases. The number of hospitalizations due to complicated and/or severe varicella was 17 cases. The median age was 6.3 years. Most of the children (82%) were immunodeficient and 18% were immunocompetent. Sixteen patients had underlying risk factors. Infectious skin and soft tissue complications were noted in most hospitalized patients (47%). They were mainly presented by cutaneous reinfections with alteration of general health (41%). Neurological complications ranked second (23%). The majority were febrile convulsions (17%). One case of bronchopulmonary complication was noted. No hematological, digestive, renal, or cardiac complications were noted. Intravenous antiviral treatment was used in 88% of hospitalized cases. The drug of choice was acyclovir. Antibiotic therapy was used in 53% of cases. No patient received corticosteroid therapy. The median length of hospitalization for our patients was 14 days. The evolution was favorable in 100% of cases.
Conclusion:
Varicella remains a benign disease in children, rarely leading to hospitalization. However, complications may develop in cases of comorbidity or children with risk factors. The introduction of the varicella vaccine into the national immunization program could considerably reduce the number of children hospitalized in the near future.
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