Periorbital varicella gangrenosa: A rare complication of chicken pox

Abstract

A previously healthy six year old male child presented in pediatrics ICU in state of shock with history of fever and rashes and later was diagnosed as chicken pox. He developed right sided periorbital varicella gangrenosa which is a form of necrotizing fasciitis secondary to skin infection. Patient was treated with intravenous acyclovir, antibiotics, amphotericin B, extensive debridement and later reconstruction of upper eyelid with skin grafting. Aggressive treatment helped preventing the eyeball and orbital involvement which would have necessitated orbital exenteration. However delayed presentation resulted in necrosis of orbicularis oculi and underlying tissue which resulted in graft retraction and lid dysfunction. Clinicians should be aware of this rare but fulminating condition to minimise the sight and life threatening complications associated with it.

Varicella Gangrenosa of Abdominal Wall: Rare but Fatal Complication of Varicella Even in Immunocompetent Healthy Children

“…Concomitant bacterial infection is a common complication in previously healthy children with chickenpox. Varicella gangrenosa is an uncommon but serious complication of chickenpox infection in young children (5,6). It constitutes less than 1% of cases.…”

Serological Evaluation of Immunity to the Varicella-Zoster Virus Based on a Novel Competitive Enzyme-Linked Immunosorbent Assay

“…Postherpetic neuralgia (PHN) is a severe sequela of HZ and the most common, especially in the aged 2 . VZV infections are more severe in immunocompromised patients and may come with severe complications, such as encephalomyelitis 3 , varicella gangrenosa 4 , myelitis 5 . Effective vaccines have been developed to prevent VZV infection 6 7 , however, they are limited by the scope of vaccination and in some cases vaccine efficacy 8 , and VZV remains an important pathogen.…”