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[Severe streptococcal complications in varicella]

M C Héraud1, Y Loriette, A Grassano

  • 1Unité de réanimation et des maladies respiratoires, CHRU de Clermont-Ferrand, Hôtel-Dieu, France.

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|May 1, 1997
PubMed
Summary

Group A beta-hemolytic streptococcal (GABHS) infections are increasingly seen with varicella in children. Early recognition of GABHS complications like septic shock and cellulitis in febrile children with varicella is crucial.

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Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Recent reports indicate a rise in group A beta-hemolytic streptococcal (GABHS) infections among children.
  • A frequent association between GABHS infections and varicella (chickenpox) has been observed.

Observation:

  • Two pediatric cases illustrate severe GABHS complications following varicella.
  • Case 1: A 3-year-old developed septic shock and osteomyelitis due to GABHS after varicella.
  • Case 2: A 4.5-year-old presented with cellulitis and adenitis, with both Staphylococcus aureus and GABHS identified.

Findings:

  • GABHS infections can manifest as severe conditions like septic shock, osteomyelitis, and cellulitis in children with varicella.
  • Early and appropriate antibiotic therapy is essential for managing these invasive streptococcal infections.

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  • Varicella can serve as a portal for secondary bacterial infections, particularly GABHS.

    • Implications:

    • Clinicians should maintain a high index of suspicion for GABHS infections in children with varicella who present with persistent fever or unusual symptoms.
    • Increased vigilance for GABHS complications is necessary in pediatric varicella cases.
    • Prompt diagnosis and management of GABHS infections associated with varicella can improve patient outcomes and prevent severe sequelae.