1/14. Lupus anticoagulant and protein s deficiency in a child who developed disseminated intravascular coagulation in association with varicella.Varicella is not always a benign disease it may cause serious complications. We report a two-year-old boy with disseminated intravascular coagulation in association with varicella. The patient had the lupus anticoagulant, the antiphospholipid antibody, acquired free protein s deficiency, and increased concentrations of the prothrombin F 1 2 fragment. Intravenous immunoglobulin was administered due to its potential antibody-blocking activity, and the patient responded well. We recommend that children with varicella and disseminated intravascular coagulation should be examined for the lupus anticoagulant, the free protein S antigen, the prothrombin fragment F 1 2 and the other coagulation parameters. Intravenous immunoglobulin administration could be useful in such conditions because of its antibody-blocking activity.- - - - - - - - - - ranking = 1keywords = varicella (Clic here for more details about this article) |
2/14. Fulminant varicella infection complicated with acute respiratory distress syndrome, and disseminated intravascular coagulation in an immunocompetent young adult.Primary varicella infection in immunocompetent adults is very rare, but it has a high mortality rate because of serious complications. We describe a case of varicella infection in a previously healthy young adult complicated with acute respiratory distress syndrome (ARDS), rhabdomyolysis, acute hepatitis and disseminated intravascular coagulation (DIC). acyclovir was administered for varicella infection and the ARDS was successfully treated with steroidpulse therapy, hemofiltration and a mechanical respiratory support with a positive end-expiratory pressure. Early administration of antiviral agents and extensive management were thought to be necessary for such patients with severe complications.- - - - - - - - - - ranking = 1.1666666666667keywords = varicella (Clic here for more details about this article) |
3/14. Ischaemic myelopathy secondary to disseminated intravascular coagulation in AIDS.A 39-year-old patient with AIDS presented with a rapidly progressive myelopathy with a partial brown-sequard syndrome. He died, 9 weeks after onset of the first neurological signs, from diffuse encephalopathy. Neuropathological examination revealed multiple, usually small, frequently haemorrhagic, infarcts or various ages and numerous fibrin thrombi in medium and small penetrating vessels and capillaries of the brain and spinal cord, characteristic of disseminated intravascular coagulation. There were no inflammatory changes. Immunohistochemical studies for human immunodeficiency virus, cytomegalovirus, varicella zoster virus, herpes simplex virus type 1 and type 2 were negative. Ischaemic spinal cord lesions due to disseminated intravascular coagulation may represent an unusual cause of focal, non-inflammatory, non-tumoral, myelopathic syndrome in AIDS.- - - - - - - - - - ranking = 0.16666666666667keywords = varicella (Clic here for more details about this article) |
4/14. Varicella gangrenosa.A four year old girl presented with varicella gangrenosa, and haematological investigations showed a disseminated intravascular coagulation. The child subsequently developed a unilateral deep venous thrombosis. She was treated with oral steroids and intravenous heparin and made a full recovery.- - - - - - - - - - ranking = 0.16666666666667keywords = varicella (Clic here for more details about this article) |
5/14. Extremity amputation: disseminated intravascular coagulation syndrome.There are occasional reports in medical literature of peripheral gangrene and subsequent extremity amputation following systemic infection. Although the authors of these case reports speculated that the gangrene was due to septic embolization, pathologic study of the amputated tissue failed to reveal evidence of septic emboli. In reviewing reports of amputation following scarlet fever, varicella, pneumococcemia, and appendicitis, we found cases with clinical, hematologic, and pathologic evidence of disseminated intravascular coagulation (DIC). We describe 2 patients who required extremity amputation following an acute, systemic infection: transmetatarsal and Lisfranc amputation following meningococcal meningitis and bilateral below-knee amputation following pneumococcal meningitis. Both of these patients had clinical, hematologic, and pathologic evidence of DIC. Following amputation, both of these patients had significant problems with skin healing and prosthetic fitting. The presence of an acute systemic bacterial or viral infection, coagulation abnormalities and pathologic tissue indicative of DIC, and skin lesions of the extremities progressing to dry gangrene and ultimately requiring bilateral amputation are the key clinical features of this syndrome. We conclude that DIC is a major pathophysiologic mechanism responsible for peripheral gangrene following systemic infection.- - - - - - - - - - ranking = 0.16666666666667keywords = varicella (Clic here for more details about this article) |
6/14. Primary varicella in adult renal transplant recipients: a report of three cases plus a review of the literature.Disseminated primary varicella zoster infection in renal transplant patients can result in severe and often fatal illness. The disease tends to be much more severe in adults with an 80% mortality in the only reported series (1). We report 3 cases of severe disseminated varicella zoster in adult renal transplant patients who all survived. early diagnosis, institution of intravenous acyclovir 10 mg/kg tds, zoster immunoglobulin, cessation of azathioprine treatment and aggressive supportive care may improve an otherwise bleak prognosis.- - - - - - - - - - ranking = 1keywords = varicella (Clic here for more details about this article) |
7/14. Varicella and thrombotic complications associated with transient protein C and protein S deficiencies in children.We report six cases of protein s deficiency secondary to varicella. Five cases were complicated by thrombotic and vascular events, namely purpura fulminans and necrotic vasculitis, deep vein thrombosis and stroke. Two cases were associated with protein c deficiency and one case revealed a heterozygous factor xii deficiency. The underlying mechanism of this acquired protein s deficiency is unclear but could be related to a direct effect of zoster virus.- - - - - - - - - - ranking = 0.16666666666667keywords = varicella (Clic here for more details about this article) |
8/14. Varicella hepatitis: a fatal case in a previously healthy, immunocompetent adult. Report of a case, autopsy, and review of the literature.Varicella, usually a benign infection of childhood, is known to be associated with more serious complications, especially in adults and immunocompromised patients. Of these, varicella pneumonitis is the most common. Primary varicella hepatitis has been described, though rarely, in immunocompromised patients. We present a case of a previously healthy human immunodeficiency virus-negative 26-year-old immigrant from el salvador in whom primary varicella developed that rapidly progressed to fulminant hepatic failure, disseminated intravascular coagulation, and death. autopsy revealed evidence of varicella in the liver, adrenal glands, and myometrium. To our knowledge, this is the first report of a fatal case of varicella hepatitis in a previously healthy, immunocompetent patient.- - - - - - - - - - ranking = 0.83333333333333keywords = varicella (Clic here for more details about this article) |
9/14. Fatal varicella infections in singapore.Varicella (chickenpox) is common in singapore. The annual incidence of reported cases for the period 1977-1990 ranged from 790 to 18,934, with a mean of 4,747. mortality from chickenpox is rare. However, failure to recognise the severity and the potential complications of the disease, especially in immunocompetent patients, exists because of the common knowledge that chickenpox is a mild and self-limiting illness. We report six cases of fatal varicella in immunocompetent patients during the period 1988 to 1990.- - - - - - - - - - ranking = 0.83333333333333keywords = varicella (Clic here for more details about this article) |
10/14. Fatal varicella zoster infection in a severe steroid dependent asthmatic patient receiving methotrexate.A case is described of fatal haemorrhagic varicella zoster in a steroid dependent asthmatic patient concurrently receiving methotrexate. The future management of patients on immunosuppressive steroid sparing drugs is discussed.- - - - - - - - - - ranking = 0.83333333333333keywords = varicella (Clic here for more details about this article) |
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