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Neuropathology of fatal varicella
Insights
True encephalitis is rare in fatal varicella cases among children. Pathological examination revealed inclusion bodies in only two unique cases, suggesting infrequent central nervous system (CNS) involvement.
Area of Science:
- Neuropathology
- Pediatric Infectious Diseases
- Viral Encephalitis
Background:
- Varicella (chickenpox) can lead to severe complications in children, including central nervous system (CNS) involvement.
- Understanding the neuropathological manifestations of fatal varicella is crucial for clinical management and prognosis.
- This study investigates the incidence and characteristics of CNS pathology in children deceased from varicella.
Observation:
- Autopsies were performed on 32 children who died from varicella.
- Twelve cases presented with acute encephalopathy and fatty liver degeneration.
- Eighteen children had pre-existing conditions, with two-thirds having received steroid treatment.
Findings:
- Demonstrable viral inclusion bodies in the brain were found in only two cases (6.25%).
- One case showed focal encephalitis with necrosis near a ventricular catheter.
- The other case, neonatal varicella, exhibited multiple disseminated necrotic foci.
Implications:
- True encephalitis is an infrequent complication of fatal varicella in pediatric cases.
- The presence of inclusion bodies is rare, suggesting alternative mechanisms for CNS dysfunction in varicella.
- Further research is needed to elucidate the pathogenesis of CNS complications in severe varicella.
Abstract:
Pathological examination of the CNS was carried out in the cases of 32 children who died of varicella. Twelve had acute encephalopathy with fatty degeneration of liver. Eighteen children had underlying disease; two thirds of them had received steroids. Two children had neonatal varicella. Only two brains of the total number of children had demonstrable inclusion bodies, and these were unique cases. One infant brain had focal encephalitis in an area of necrosis around a ventricular catheter, and the other, a case of neonatal varicella, had multiple disseminated necrotic foci. These observations suggest that true encephalitis is a rare event in fatal varicella.