1988
DOI: 10.1016/0091-6749(88)90219-9
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Fatal varicella in steroid-dependent asthma

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Cited by 47 publications
(18 citation statements)
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“…This is consistent with previous reports (totaling 31 patients who died after similar presentations) that abdominal and/or back pain, often preceding the appearance of skin lesions, is an ominous sign and portends a severe course. 5,20,21 Thus, in an immunocompromised patient with unexplained back or abdominal pain, the early empiric use of acyclovir should be considered, even in the absence of other symptoms or signs of varicella. Both patients in this report first developed vesicles in the genital area, highlighting the need for a thorough skin examination in the febrile immunocompromised patient.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…This is consistent with previous reports (totaling 31 patients who died after similar presentations) that abdominal and/or back pain, often preceding the appearance of skin lesions, is an ominous sign and portends a severe course. 5,20,21 Thus, in an immunocompromised patient with unexplained back or abdominal pain, the early empiric use of acyclovir should be considered, even in the absence of other symptoms or signs of varicella. Both patients in this report first developed vesicles in the genital area, highlighting the need for a thorough skin examination in the febrile immunocompromised patient.…”
Section: Discussionmentioning
confidence: 99%
“…Small series and case reports in children have noted an association between steroid therapy and severe VZV infections. [1][2][3][4][5][6][7][8] In children with acute lymphoblastic leukemia (ALL), steroid therapy and its relation to VZV severity have not been well studied. We hypothesized that patients who received recent (within 3 weeks) steroid therapy for ALL were at higher risk for severe varicella infection compared with those who had not been treated recently (Ͼ3 weeks) with steroids.…”
mentioning
confidence: 99%
“…Although usually mild among children, varicella is often severe and occasionally life threatening in adults, particularly in those whose immune systems have been suppressed by disease or treatment with corticosteroids 2,3. Corticosteroids are widely prescribed: over 5.5 million prescriptions for systemic corticosteroids were issued by general practitioners in the United Kingdom for the year ending September 1993 (Intercontinental Medical Statistics, personal communication).…”
mentioning
confidence: 99%
“…Moreover, the safety of this procedure has yet to be examined. In view of the possible association between the fatal varicella and oral steroids [42][43][44][45], it is prudent to recommend that all asthmatic children be adequately vaccinated, particularly for varicella if susceptible. Because of the potential for abuse, it appears safe to recommend the prescription of only one short course of oral steroids at a time, with no refill, and a repeat assessment after each utilization.…”
Section: Oral Steroidsmentioning
confidence: 99%