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Titolo:
Varicella in immunocompetent children: Complications and risk factors
Autore:
Floret, D;
Indirizzi:
Hop Edouard Herriot, F-69437 Lyon 03, France Hop Edouard Herriot Lyon France 03 uard Herriot, F-69437 Lyon 03, France
Titolo Testata:
MEDECINE ET MALADIES INFECTIEUSES
fascicolo: 11, volume: 28, anno: 1998,
pagine: 775 - 781
SICI:
0399-077X(199811)28:11<775:VIICCA>2.0.ZU;2-B
Fonte:
ISI
Lingua:
FRE
Soggetto:
A STREPTOCOCCAL INFECTIONS; ZOSTER VIRUS; ACYCLOVIR TREATMENT; PURPURA FULMINANS; HEALTHY-CHILDREN; REYES-SYNDROME; CHICKENPOX; CORTICOSTEROIDS; ASSOCIATION; THROMBOSIS;
Keywords:
varicella; child; complications; death; risk factors;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
61
Recensione:
Indirizzi per estratti:
Indirizzo: Floret, D Hop Edouard Herriot, 5 Pl Arsonval, F-69437 Lyon 03, France Hop Edouard Herriot 5 Pl Arsonval Lyon France 03 yon 03, France
Citazione:
D. Floret, "Varicella in immunocompetent children: Complications and risk factors", MED MAL INF, 28(11), 1998, pp. 775-781

Abstract

Varicella is a common disease due to varicella-zoster virus affecting mainly the children and usually self-limited. However, a lot of complications have been reported in 3-5 % of the patients, with an estimated mortality rate at 1.4/100 000. Most of the deaths occur in immunocompetent people. Bacterial complications are most prevalent. Staphylococcus aureus and Streptococcus pyogenes are the main bacteria involved. Among them, necrotizing fasciitis is the most severe with a recent apparent increasing incidence. Among neurological complications cerebellar ataxia is the most prevalent, with a usual favorable outcome. Meningoencephalitis is rare but may be severe. The Reye's syndrome has been rarely reported since the advice against administration of aspirin in the course of varicella has been given. The other complications reported are myelitis, Guillain Barre syndrome, and optic neuritis. Pneumonia is a rare complication in children except in infants with a significant risk of death. A lot of rare complications have been reported : hepatitis, usually asymptomatic, thrombocytopenia, vascular thrombosis including purpura fulminans which may lead to to severe limb amputations. Glomerulonephritis have been reported as arthritis. Varicella in eye is the most prevalent ocular complication, others as uveitis or keratitis being rare. Myocarditis, pericarditis, orchitis, pancreatitis have also been reported. Some risk factor for severe or complicated varicella have been identified. The main one is the age : children < 5 year have a higher risk for complications, particulary infectious. The mortality rate is 4 times higher in infants < 1 year, as compared to older children. Adolescents exhibit more severe forms of varicella. The respective prevalence of the different complications is also conditionned by age. After an intrafamilial contamination the secondary cases use to be more severe, as compared to primary cases, with an increasing number of vesicules and an additionnal risk for infectious complications. Chronic cutaneous diseases, mainly atopic eczema is said to predispose to severe forms of varicella. Indeed, this evidence is not really documented. The consequenses seem to be an increased number of vesicules with an unusual distribution. Asthma seems to be a risk factor for severe varicella as it results in corticosteroids administration. Long-term administration of corticosteroids results in a well known increased risk of severe varicella. Furthermore, some cases of lifethreatening varicella have been reported following a short single course of high dose corticosteroids administration and even in asthmatic children treated by inhaled corticosteroids. However, these data are still controversial. Finally, the available data on risk factors seem to be too scarce and controversial to be able to propose definitve recommandations with respect to the best way to prevent severe complications in varicella.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/12/20 alle ore 11:04:02