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Órgano Oficial de la Sociedad
Latinoamericana de lnfectología Pediátrica.
Órgano de la Asociación Mexicana de
Infectología Pediátrica, A.C.
Órgano difusor de la Sociedad Española
de lnfectología

2017, Number 3

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Rev Latin Infect Pediatr 2017; 30 (3)

Descending necrotizing mediastinitis in an immunocompetent child with chickenpox. Case report and literature review

Hernández PM, González SN, Aguilar GNE, Fuentes SS, Díaz FN

Language: Spanish
References: 10
Page: 122-126
PDF size: 276.92 Kb.


ABSTRACT

Chickenpox is an exanthematic disease caused by highly contagious Herpes virus Varicela Zoster (VZV). The clinical spectrum is variable, since it can present from a table with few vesicles, up to a disease with multiple lesions and important decay. Among the most frequent complications in previously healthy children are cutaneous superinfections that can sometimes be the initial focus of a bacteriemic or septic process, or a syndrome mediated by staphylococcal or streptococcal toxins, neurological complications, pulmonary complications, haematological complications. Due to the very rare association between chickenpox and descending necrotizing Mediastinitis (DNM), we review a case that began with characteristic lesions and an evolution with persistent fever, data of progressive respiratory distress evolving to septic process despite prolonged antiviral and antimicrobial treatment. It was complicated by bilateral pleural effusion, with persistent fever and systemic deterioration. Subsequent descending necrotizing mediastinitis was found to be a serious complication that reported a mortality of 50%. In the literature, only one case of DMN secondary to chickenpox in the pediatric age was reported. Vaccination for chickenpox is necessary for the entire population, especially children under five, given the great morbidity of the disease with severe complications.


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