Question of the Week

Question :
Posted On : 10 Jan 2007
A 20 month old girl brought to emergency room with acute onset of generalized weakness followed by sudden decreased level of consciousness and apnea and after CPR she was sent to PICU in another hospital 2-3 hours later. She has received conservative treatment during last 5 days for chickenpox with one dose of intramuscular betamethasone, oral hydroxyzin, acetaminophen, amoxicillin. After admission in PICU she developed gastrointestinal bleeding and gross hematuria. On lab tests she had prolonged PT and PTT, normal liver enzymes, gradual increase in BUN and Creatinine, gradually decrease in platelet count and hemoglobin. Lumbar puncture was done on 1st and 10th day of admission. The 1st one had 30 fresh RBC with normal protein and sugar and second one had normal glucose, increased protein {76}, 5 Lymphocytes, Xanthochromic. I wanted to know if such complications are reported with varicella zoster virus and if not what can be the diagnosis. THANKS A LOT
5
Expert Answer :
No expert answer available.
Answer Discussion :
D
DR KEDAR N. SAWLESHWARKAR
Profile
HERPES ENCEPHALITIS CAN PRESENT WITH HEMORRHAGIC CSF.
18 years ago
M
moawia
Profile
Yes, such complications are reported with varicella zoster virus
*Viral pneumonia
*Encephalitis
*Haemorrhagic chickenpox - haemorrhagic symptoms sometimes occur during the course of varicella and usually present 2 - 3 days after the onset of the rash. Haemorrhage into the skin, epitaxis, malaena or haematuria may be present. The haemorrhage may be so severe as to be life threatening. Although thrombocytopenia and DIC occur during varicella, nothing is known about the pathogenesis of this serious complication.

18 years ago
S
sky
Profile
i think it is reported when as very young children and older age group{two extremes of age }can develop severe infection especially hemorrhagic varicella infection and also encephalitis .its very possible .any patient coming with borderline consciousness level or suspicious history with varicella should bestarted on IV acyclovir to prevent such sevre infection or progression of disease
18 years ago
S
samir
Profile
herpes zoster if it occurs in immuno-compromised patients , it can lead to systemic spread and complications like pneumonitis, encephalitis and progressive zoster over multiple dermatomes.
however in this case the condition is associated wit DIC as prolonged PT.PTT and gradual decreased of PLT
so i thimk the final diagnosis in that case is septicemia with DIC dueto systemic infection. with varicella zoster
thanks : DR - samir sobhi abu dalo

18 years ago
S
saeedelsadek
Profile
it looks like acute dissiminated encephalomylitis
18 years ago




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