Clinical characteristics of bacterial complications of chickenpox in children

Abstract

The article presents data on the frequency of development and clinical course of bacterial complications of chickenpox in children aged from 2 months to 18 years, who were treated at inpatient department of Infectious Diseases Communal Clinical Hospital in Lviv and surgical department of Communal Municipal Children’s Clinical Hospital in 2000–2016. Bacterial complications were diagnosed in 136 patients (27.2 % out of total number of hospitalized children with chickenpox). Among the complications of chickenpox – lesions of the skin, underlying soft tissues and mucous membranes dominated (43.4 %): surface (pyoderma, erysipelas, conjunctivitis, blepharitis, gingival stomatitis), deep circumscribed (furuncle, abscess), as well as deep non-circumscribed (phlegmons) lesions of various body regions. Particularly severe flow was characterized by phlegmon, which developed in 18.4 % of children, 68% of them with mild forms of chickenpox. Most frequently, phlegmons were diagnosed in children under age 4 years. The first clinical symptoms (swelling and hyperemia with distinct margins, acute tenderness on palpation) appeared on the 3rd–10th day of the disease. Complication of respiratory organs – pneumonia, was diagnosed in 30.1 % of patients. The development of pneumonia was primarily observed in severe forms of chickenpox. Pneumonia, as a rule, developed on the 4th–10th day of the disease and was accompanied by intensification of the signs of intoxication syndrome, appearance of respiratory failure manifestations, cough. Other bacterial complications of chickenpox were also observed in patients: purulent otitis (7.4 % of patients), phlegmonous appendicitis (5.1 %), lacunar tonsillitis (4.4 %), pyelonephritis (3.7 %) cervical lymphadenitis (2.2 %), erosive gastroduodenitis (1.5 %), purulent meningitis (1.5 %), and osteomyelitis (0.7 %). On bacteriological examination of the content, obtained in surgical interventions from the lesion regions in 26 (19.1 %) children, pathogenic and conditionally pathogenic bacteria were isolated. Dominant etiological agents were S. pyogenes та S. aureus.