Cardiac tamponade after varicella infection
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Updated: Aug 15, 2026

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Published on: July 18, 2014
Insights
Varicella zoster virus infection can rarely cause severe heart complications in children, including cardiac tamponade. Early recognition of this rare myopericarditis is crucial for timely intervention.
Area of Science:
- Pediatrics
- Infectious Diseases
- Cardiology
Background:
- Varicella zoster virus (VZV) infection is common in childhood.
- Myopericarditis is a rare but serious complication of VZV infection.
- Cardiac complications can range from subclinical changes to severe heart failure.
Observation:
- A 4-month-old infant presented with cardiac tamponade and large pericardial effusion.
- Symptoms appeared two weeks after a varicella exanthem.
- Streptococcus was observed in pericardial fluid but not cultured; clinical course suggested viral myopericarditis.
Findings:
- Varicella infection can lead to significant myopericardial disease in infants.
- Pericardial effusion and cardiac tamponade are potential severe outcomes.
- Viral etiology is suspected despite transient bacterial presence in pericardial fluid.
Implications:
- Highlights the potential for severe cardiac complications from VZV in children.
- Emphasizes the need for early diagnosis and management of varicella-associated myopericarditis.
- Informs clinical practice regarding the spectrum of VZV-related cardiac disease.
Unlabelled:
Infection with varicella zoster virus is common in childhood and generally associated with few complications. Myopericarditis following varicella infection is rare but may result in severe rhythm disturbances and congestive cardiac failure. The case is presented of a 4-month-old infant presenting with a large pericardial effusion and cardiac tamponade 2 weeks after the onset of a varicella exanthem. Although Streptococcus was noted in the pericardial fluid, it could not be grown on bacterial culture and the subsequent clinical course was in keeping with a viral myopericarditis.
Conclusion:
Varicella infection in children may be complicated by myopericardial disease ranging from subclinical ECG changes to fulminant cardiac failure and/or cardiac tamponade. The clinical spectrum of this unusual complication is reviewed and the importance of early recognition emphasised.
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