Cases reported "Chickenpox"

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1/7. Development of mixed-type autoimmune hemolytic anemia and Evans' syndrome following chicken pox infection in a case of low-titer cold agglutinin disease.

    We describe a patient with low-titer cold agglutinin disease (CAD) who developed mixed-type autoimmune hemolytic anemia (AIHA) and idiopathic thrombocytopenia following chicken pox infection. At least 1 year before admission to hospital, the patient had mild hemolytic anemia associated with low-titer cold agglutinins. A severe hemolytic crisis and thrombocytopenia (Evans' syndrome) occurred several days after infection with chicken pox, and the patient was referred to our hospital. Serological findings revealed the presence of both cold agglutinins and warm-reactive autoantibodies against erythrocytes, and the diagnosis was mixed-type AIHA. Following steroid therapy, the hemoglobin (Hb) level and platelet count improved. The patient was closely followed over a 10-year period with recurrent documented hemolysis after viral or bacterial infections. Warm-reactive autoantibodies have not been detected in the last 2 years, and only the immunoglobulin m anti-I cold agglutinins with a low titer and wide thermal amplitude have remained unchanged. Therefore, the patient has received at least 10 mg prednisolone daily to maintain a Hb level of 10 g/dL. To the best of our knowledge, no adult case of low-titer CAD that has evolved into mixed-type AIHA and Evans' syndrome after chicken pox infection has been previously reported in the literature.
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keywords = bacterial infection
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2/7. A transient granulocyte killing defect secondary to a varicella infection.

    A varicella infection in a previously healthy young girl was complicated by bacterial sepsis, arthritis, and osteomyelitis in multiple locations. This secondary complication caused by staphylococcus aureus was associated with a transient defect in granulocyte function and an alteration in the representation of CD4 and CD8 positive lymphocyte subpopulation. The mechanism responsible for secondary bacterial infections following varicella may be due to transient defects in granulocyte function.
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keywords = bacterial infection
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3/7. Varicella-zoster virus infections in children infected with human immunodeficiency virus.

    Primary varicella-zoster (VZ) infection in eight children with perinatally acquired human immunodeficiency virus infection tended to be severe, prolonged, complicated by bacterial infections and in one case fatal. Depletion of CD4-lymphocytes was associated with chronic and recurrent VZ infection. In some patients convalescent VZ antibody titers were low and did not correlate with recurrence of VZ lesions. Administration of acyclovir appeared to be beneficial in suppressing VZ in human immunodeficiency virus-infected children with primary or recurrent VZ infection.
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keywords = bacterial infection
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4/7. Group A streptococcal necrotizing fasciitis complicating primary varicella: a series of fourteen patients.

    We retrospectively reviewed the clinical course of group A streptococcus necrotizing fasciitis complicating primary varicella in children admitted to Children's Hospital and Medical Center, Seattle, WA, during a 18-month period. The potential benefit of various therapeutic interventions was examined. Fourteen children ages 6 months to 10 years were treated for group A streptococcus necrotizing fasciitis as a complication of primary varicella. Eight patients experienced a delay in initial diagnosis as a result of nonspecific, early clinical findings of necrotizing fasciitis. Each patient underwent surgical exploration with fasciotomies and debridement. Initial antibiotic therapy was broad spectrum and included clindamycin. Hyperbaric oxygen therapy for as many as 6 treatments was used as adjunctively therapy in 12 patients, with subjective benefit in 6 patients. All 14 patients were discharged home with good function and no long term sequelae. This potentially fatal bacterial infection of the deep fascial layers requires early recognition by primary care physicians and an intensive, multidisciplinary therapeutic approach, including thorough surgical debridement and appropriate antibiotic therapy.
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keywords = bacterial infection
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5/7. Langerhans cell histiocytosis presenting as a varicelliform eruption over the entire skin.

    A boy with skin eruptions resembling varicella and specific for Langerhans cell histiocytosis (LCH) is reported. At his initial visit when he was four months old, vesiculopustular lesions were present over the entire body; these had first appeared on the third day post partus. Histopathological, immunohistochemical, and electron microscopical examination confirmed the Langerhans cell phenotype and Birbeck granules in the responsible cells. He also had hydronephrosis, recurrent fever, and cutaneous bacterial infections. His parents refused further medical treatment and he died of diarrhea with cachexia about two years later. LCH may present diagnostic difficulties by manifesting as a skin eruption which resembles varicella.
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keywords = bacterial infection
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6/7. Pyogenic arthritis complicating varicella infection.

    arthritis has not previously been reported as a complication in adult patients with chickenpox. In pediatric patients, the arthritis that complicates chickenpox is most commonly aseptic but does rarely result from bacterial infection. We report the case of a 21-year-old man who developed acute monoarticular septic arthritis due to Lancefield Group A beta-hemolytic streptococci. Despite the more common viral cause of arthritis in pediatric patients, physicians should not attribute arthritis associated with varicella in adults to a viral cause without diagnostic arthrocentesis.
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keywords = bacterial infection
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7/7. Complications of varicella pneumonia in adults.

    Varicella is predominantly a disease of children, in whom it typically has a benign course and outcome. However, when the disease affects adults, the complications can be life-threatening. Varicella pneumonia, secondary bacterial infection, and opportunistic infection in the immunocompromised host are the most common complications in the adult. Surveillance for these complications is mandatory because appropriate therapy may be life-saving. The introduction of specific antiviral agents may be useful in certain clinical circumstances. The authors describe two representative patients and discuss the diagnosis and treatment. They also discuss this infection in adulthood in general.
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keywords = bacterial infection
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