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題名 | Complications of Varicella in Children: Emphasis on Skin and Central Nervous System Disorders=兒童水痘感染之併發症:著重於皮膚及中樞神經系統的合併症 |
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作者 | 曾慧菀; 劉清泉; 王世敏; 楊燿榮; 黃義盛; | 書刊名 | 微免與感染雜誌 |
卷期 | 33:4 2000.12[民89.12] |
頁次 | 頁248-252 |
分類號 | 417.516 |
關鍵詞 | 兒童; 水痘; 皮膚; 中樞神經系統; Children; Complication; Encephalitis; Skin infection; Varicella; |
語文 | 英文(English) |
英文摘要 | A Review of medical records at a tertiary hospital in southern Taiwan from June 1988 through May 1998 identified 136 children who had been hospitalized for varicella-related complications. Of the children, 83% (113/136) were healthy before the onset of varicella and 17% (23/136) had underlying illnesses. The mean age was 4.7 years (ranged from 1 day to 18 years) with a male predominance (1.7:1). The mean hospital stay was 5.5 days (ranged from 1 to 22 days). Secondary bacterial skin or soft tissue infections were the most common complications (44%), followed by central nervous system (CNS) involvement (23%), pneumonia (18%), thrombocytopenia (12%), and liver function impairment (10%). Among the 60 patients with secondary bacterial cutaneous infection, 16 (27%) had positive isolates, including 12 isolates of Staphylococcus aureus and four Streptococcus pyogenes. Age above 8 years was significantly associated with the development of varicella-associated CNS complications (p=0.019). Of the 23 immunocompromised hosts, the most common underlying conditions were hematological diseases (11 patients, 48%), followed by neonatal varicella (7 patients, 30%) and chronic illness with steroid treatment (5 patients, 22%). All of the subjects in this study had a favorable outcome except for three lethal cases, resulting in a case-fatality rate of 2.2%. The cause of death was S. aureus septicemia in one patient, streptococcal toxic shock syndrome in one patient, and encephalitis with brain herniation in one patient. Our results demonstrate that varicella continues to be a serious disease that occasionally results in life-threatening complications in healthy and immunocompromised children. Routine immunization of all healthy children against varicella is recommended. |
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