1/4. fatal outcome of varicella in children.Varicella or chicken-pox are one of the most frequent diseases in childhood. Severe or even lethal complications are rare (in about 0.03 per thousand ). Our paper presents two cases of varicella infections leading to sudden deaths (3- and 7-year-old children). In one of these cases, the paediatrician in charge was accused of an impaired medical treatment. Both of the children showed multiple typical efflorescences in different stages. Furthermore were observed affections of the respiratory tracts and serious involvements of the hearts, the lungs, and the livers. In one case an immunological identification could be made of an acute varicella infection. Based on autoptical, histological, bacteriological, virological, and neuropathological findings is given an analysis of such uncommon and severe courses of chicken-pox in children being identified as haemorrhagic form and massive abscess-forming varicella pneumonia.- - - - - - - - - - ranking = 1keywords = varicella (Clic here for more details about this article) |
2/4. Sudden unexpected death in a child with varicella caused by necrotizing fasciitis and streptococcal toxic shock syndrome.A 4-year-old child with chickenpox infection for 5 days prior to death complained of swelling and pain in his right leg that required medical assistance in the emergency department. Radiologic study was normal, and analgesic and bandage of the leg were prescribed. Some hours later, he presented cyanosis, dizziness, and vomiting and collapsed. A complete forensic autopsy was performed 12 hours after death. External examination of the body showed numerous crusty varicella skin lesions, especially over the trunk, and swelling and reddening of his right leg. The brain was swollen, with cerebellar herniation, and both adrenal glands were hemorrhagic.Microscopically, neutrophilic infiltration and muscle fiber necrosis were observed in soft tissues of his right leg, and fibrin microthrombus were numerous in capillaries of the plexus choroideus, larynx, lungs, and adrenals. Bacterial emboli were present in most of the tissues. Microbiologic cultures of blood and cerebrospinal fluid showed group A beta-hemolytic streptococcus (streptococcus pyogenes). death was attributed to fulminant streptococcal toxic shock syndrome, with necrotizing fasciitis as a complication of varicella.- - - - - - - - - - ranking = 0.85714285714286keywords = varicella (Clic here for more details about this article) |
3/4. Fatal varicella in a healthy young adult.A healthy adult presented with severe neurological disturbance 4 d after developing chicken-pox. Although pneumonic and renal problems were also present the neurological state dominated the clinical picture. After the patient's sudden death an autopsy revealed that renal and cerebral problems were secondary to myocardial involvement. This was of an unusual type for varicella with features of dilated cardiomyopathy resembling that previously related to Coxsackie infections. We conclude that cardiac problems in this patient produced anoxic brain damage and subsequently death.- - - - - - - - - - ranking = 0.71428571428571keywords = varicella (Clic here for more details about this article) |
4/4. Varicella-zoster virus replication site in internal organs of an otherwise healthy child with varicella and sudden death.Pathological findings of an otherwise healthy 17 month old boy who was exposed to Varicella-zoster virus (VZV) in his family and unexpectedly died 3 days after onset of varicella are reported. They showed a disseminated VZV infection with involvement of skin, lung, liver, spleen, gastrointestinal tract and other organs where VZV antigen was detected by the enzyme-immunoassay with monoclonal antibodies to VZV. Since the subject was the full-term product of an uncomplicated pregnancy, who grew and developed normally, and had no symptoms or laboratory findings suggestive of immunodeficiency until his death, these findings suggest that many organs are involved as major internal sites of viral replication before or during infection of skin with VZV in the immunocompetent host.- - - - - - - - - - ranking = 0.71428571428571keywords = varicella (Clic here for more details about this article) |