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[Severe streptococcal group A infection complicating varicella]
D Briard1, P Bétrémieux, V Gandemer
1Unité de réanimation pédiatrique, hôpital de Pontchaillou, Rennès, France.
Summary
Group A Streptococcus (GAS) superinfection is a serious complication of varicella (chickenpox). Early recognition and multidisciplinary treatment are crucial for favorable outcomes in children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Rheumatology
Background:
- Varicella (chickenpox) is a common viral illness, typically benign in children.
- Severe group A Streptococcus (GAS) superinfections can complicate varicella, leading to significant morbidity.
Observation:
- A previously healthy 2-year-old girl developed leg pain, limb edema, and toxic shock syndrome during varicella.
- Imaging revealed hip effusions, necrotizing fasciitis, and osteomyelitis of the left leg.
Findings:
- Blood cultures confirmed beta-hemolytic group A Streptococcus.
- Despite initial treatment, advanced imaging indicated severe soft tissue and bone infection.
- The child received a combination of antibiotics and immobilization, leading to recovery without sequelae.
Implications:
- Group A Streptococcus infection is a critical, albeit rare, complication of varicella that requires prompt medical attention.
- Joint pain during or after varicella warrants consideration of GAS infection.
- Effective management necessitates collaborative care among pediatricians, infectious disease specialists, radiologists, and orthopedic surgeons.