Our results seem to indicate that there is an almost perfect agreement in the qualitative identification of delayed cortical transit among physicians with experience at observing renographic images.
Objective: To report a case of varicella complicated by acute osteomyelitis in order to
remind of a rare and potentially serious complication of a very common
pediatric disease.Case description: A previously healthy 3-month-old female infant with 10-day history of
varicella was admitted to the hospital for fever, groan and prostration. The
initial laboratorial evaluation was compatible with bacterial sepsis. By the
third day after admission, a swelling of the seventh left rib had developed.
The ultrasound and scintigraphy evaluation suggested rib osteomyelitis.
Blood cultures were negative. The patient completed six weeks of antibiotics
with favorable clinical, laboratorial and imaging evolution.Comments: Varicella is one of the most frequent exanthematic diseases of childhood and
it is usually self-limited. The most frequent complication is bacterial
infection of cutaneous lesions. Osteoarticular complications are rare, and
rib osteomyelitis is described in less than 1% of cases. The main route of
dissemination is hematogenic, and the most frequent etiological agent is
Staphylococcus aureus. The prognosis is generally good
and depends on early detection and antibiotic initiation.
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