Cluster of cutaneous severe complications of varicella

Introduction: The most common complications of varicella are the cutaneous infection, due in the majority of cases to the Streptococcus pyogenes. Aim: To present four cases of varicella with severe cutaneous complications that required hospital admission. All four presented in our Area of Health during the same period of time (April-May 2000). Patients and Methods: Retrospective review of the in-patient children suffering from varicella that presented severe cutaneous complications. Results: The sample included four children between 13 months and 3 and a half years of age. Two of them had a past history of atopic reactions without anything else of interest. During the course of the varicellous eruption there were in all cases high fever, malaise and various type of lesions due to cutaneous overinfection (cellulitis, adenitis, fasciitis). Therefore these patients had to be admitted to hospital for antibiotic treatment and surgical debridment in three of the cases. Two of the cases presented torpid progress but it was favourable in the rest. Conclusions: ? To notice the coincidence in time of the four cases of varicella complicated with severe supurative skin manifestations. ? In two of the cases there was an underlying pathology of atopia that together with the existence of more aggressive serotypes of Streptococcus pyogenes it could explain the greater severity of the infection. ? It is advisable to do blood cultures in those cases of varicella with cutaneous complications. ? Cases like this must encourage us to think about the use of Aciclovir in varicella and the instauration of a systematic antivaricellous immunisation program in our area.