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1.
Rinsho Ketsueki ; 61(8): 870-873, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32908048

RESUMO

A 58-year-old man received high-dose melphalan with autologous peripheral blood stem cell transplantation for multiple myeloma in stringent complete response (sCR). Relapse occurred 4 years after the transplantation, and he was placed on ixazomib, lenalidomide, and dexamethasone (IRd) and achieved sCR. On the 10th day of the 10th course of IRd, he developed fever followed by generalized skin eruption with vesicles, headache, and dizziness. Varicella-zoster virus (VZV) antigen from the vesicle and VZV-DNA from the cerebrospinal fluid were detected, and he was diagnosed with systemic VZV infection. He was placed on intravenous acyclovir (ACV), and the infection resolved completely. VZV infection has been recognized as an important complication associated with the use of proteasome inhibitors; however, to our knowledge, there have been no reported cases of serious systemic VZV infection associated with ixazomib. The clinical course of this case strongly suggests the importance of prophylaxis for VZV infection during treatment with ixazomib.


Assuntos
Compostos de Boro/uso terapêutico , Varicela , Glicina/análogos & derivados , Herpes Zoster , Mieloma Múltiplo , Varicela/complicações , Glicina/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/complicações , Mieloma Múltiplo/tratamento farmacológico , Recidiva Local de Neoplasia
2.
BMC Infect Dis ; 20(1): 454, 2020 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-32600274

RESUMO

BACKGROUND: Varicella zoster virus (VZV) causes varicella primarily in childhood, and some rare adults also report varicella. Herpes zoster mainly occurs in adults by endogenous reactivation of latent VZV. Until now, varicella and herpes zoster have seldom been reported simultaneously in one patient. Here, we report a rare case co-presenting with varicella and herpes zoster in a Chinese adult. CASE PRESENTATION: A 44-year-old Chinese man suffered papules and vesicles with pain on the left ear. Five days after onset, he was admitted to the Department of Dermatology of The Third Hospital of Xiamen. Physical examination revealed that small vesicles surrounded by erythema had developed on his trunk, back and neck, and unilateral papules and vesicles in ribbons had also developed on the left ear. This patient was excluded from human immunodeficiency virus and Treponema pallidum infections by ELISA antibody tests. Laboratory tests revealed that the ratio of eosinophils (0.1%) and eosinophil count (0.0 × 109/L) were significantly downregulated. Treatment with valacyclovir, ebastine, mecobalamine, pregabalin and calamine lotion for 5 days was effective therapy for varicella and herpes zoster. Polymerase chain reaction for vesicular fluids from varicella and herpes zoster was positive for VZV, and further phylogenetic analysis and single nucleotide polymorphism variations confirmed that the VZV genotype was type J (clade 2). CONCLUSIONS: This rare case highlights awareness of varicella and herpes zoster caused by VZV infection in adults. Our report provides novel insight into the rare clinical presentation of VZV genotype J.


Assuntos
Varicela/complicações , Genótipo , Herpes Zoster/complicações , Herpesvirus Humano 3/genética , Adulto , Antivirais/uso terapêutico , Varicela/tratamento farmacológico , Varicela/virologia , China , Combinação de Medicamentos , Compostos Férricos/uso terapêutico , Herpes Zoster/tratamento farmacológico , Herpes Zoster/virologia , Antagonistas dos Receptores Histamínicos H1/uso terapêutico , Humanos , Masculino , Filogenia , Reação em Cadeia da Polimerase , Polimorfismo de Nucleotídeo Único , Resultado do Tratamento , Óxido de Zinco/uso terapêutico
4.
BMC Infect Dis ; 20(1): 54, 2020 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-31952510

RESUMO

BACKGROUND: Varicella is normally a self-limited childhood disease caused by varicella-zoster virus infection. However, it sometimes causes severe diseases, especially in immunocompromised individuals. We report a case of severe varicella in a young woman. CASE PRESENTATION: A 19-year-old woman presented to the emergency department with abdominal pain and a rash after taking methylprednisolone for 2 weeks for systemic lupus erythematosis. The laboratory data showed leukocytosis, thrombocytopenia, an elevated level of the liver transaminases and disseminated intravascular coagulation. Computed tomography of the abdomen revealed multiple air-fluid levels in the intestines. Hemorrhagic varicella was considered and antiviral therapy as well as immunoglobin were applied. Her condition deteriorated and she eventually died due to multi-organ failure and refractory shock. Next-generation sequencing performed on fluid from an unroofed vesicle confirmed the diagnosis of varicella. CONCLUSION: In its severe form, VZV infection can be fatal, especially in immunocompromised patients. Hemorrhagic varicella can be misdiagnosed by clinicians because of unfamiliar with the disease, although it is associated with a high mortality rate. In patients with suspected hemorrhagic varicella infection, antiviral therapies along with supportive treatment need to be initiated as soon as possible in order to minimize the case fatality rate.


Assuntos
Varicela/diagnóstico , Abdome/diagnóstico por imagem , Dor Abdominal/etiologia , Antivirais/uso terapêutico , Varicela/complicações , Varicela/tratamento farmacológico , Varicela/virologia , DNA Viral/química , DNA Viral/metabolismo , Feminino , Herpesvirus Humano 3/genética , Herpesvirus Humano 3/isolamento & purificação , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Hospedeiro Imunocomprometido , Insuficiência de Múltiplos Órgãos/diagnóstico , Insuficiência de Múltiplos Órgãos/etiologia , Análise de Sequência de DNA , Tomografia Computadorizada por Raios X , Adulto Jovem
5.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 37(4): 510-515, Oct.-Dec. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1041364

RESUMO

ABSTRACT 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.


RESUMO Objetivo: Descrever um caso de varicela complicada de osteomielite aguda a fim de alertar para a complicação rara e potencialmente grave de uma doença muito frequente em idade pediátrica. Descrição do caso: Lactente de três meses, previamente saudável, internada por um quadro de febre, prostração e gemido, num contexto de varicela com cerca de dez dias de evolução, com avaliação inicial compatível com sepse de etiologia bacteriana. No terceiro dia de internação, observou-se uma tumefação na sétima costela esquerda. A avaliação ecográfica e cintilográfica mostraram alterações sugestivas de osteomielite de arco costal. As hemoculturas foram negativas. Recebeu antibioticoterapia por seis semanas e evoluiu favoravelmente do ponto de vista clínico, laboratorial e ecográfico. Comentários: A varicela é uma das doenças exantemáticas mais frequentes da infância, sendo habitualmente autolimitada. A complicação mais frequente é a infecção bacteriana secundária das lesões cutâneas, sendo raras as complicações osteoarticulares. O arcabouço costal é uma localização excepcional de osteomielite, descrita em menos de 1% dos casos. A principal via de disseminação é a hematogênica, e o agente mais frequente, o Staphylococcus aureus. O prognóstico é geralmente bom, quando a antibioticoterapia se institui precocemente.


Assuntos
Humanos , Feminino , Lactente , Osteomielite/diagnóstico , Osteomielite/virologia , Varicela/complicações , Costelas
6.
BMJ Case Rep ; 12(11)2019 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-31780611

RESUMO

Cryoglobulins are abnormal serum immunoglobulins that tend to precipitate in intravascular compartments at temperatures lower than 37°C causing blood flow restriction to vital organs. They are divided into type I, II and III based on the immunoglobulin subtypes of the cryoprecipitates. Type II cryoglobulinemia is most commonly associated with viral infections, autoimmune diseases and lymphoproliferative disorders. Here, we reported an 80-year-old man who presented with fatigue, acute kidney injury, palpable purpura, anaemia and altered mental status. He was diagnosed with type II cryoglobulinemia with concomitant positive autoimmune markers, varicella IgM antibody and IgM hepatitis B core antibody. The patient responded well to intravenous and oral steroid treatment.


Assuntos
Doenças Autoimunes/complicações , Varicela/complicações , Crioglobulinemia/complicações , Hepatite B/complicações , Idoso de 80 Anos ou mais , Doenças Autoimunes/sangue , Biomarcadores/sangue , Varicela/sangue , Crioglobulinemia/sangue , Crioglobulinemia/classificação , Hepatite B/sangue , Humanos , Masculino
7.
Indian J Pathol Microbiol ; 62(4): 592-594, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31611447

RESUMO

Sympathetic ophthalmia (SO) is a rare bilateral diffuse granulomatous panuveitis that occurs in few days to several years after penetrating injury. This intraocular inflammation can occur in any age group without a sex predilection. Pathology and immunohistochemistry-supported evidence is important to know the disease in a better way. We present a case of a 24-year-old female with clinical diagnosis of SO with an atypical past history of chicken pox in that eye and residual corneal opacity.


Assuntos
Varicela/diagnóstico , Achados Incidentais , Oftalmia Simpática/diagnóstico , Oftalmia Simpática/virologia , Varicela/complicações , Opacidade da Córnea/virologia , Olho/patologia , Olho/virologia , Feminino , Humanos , Imuno-Histoquímica , Adulto Jovem
8.
Ir Med J ; 112(7): 966, 2019 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-31553147

RESUMO

Aim The aim of this study was to evaluate trends in admissions for patients with primary varicella infection in Irish hospitals. Methods The Hospital Inpatient Enquiry System was evaluated from Irish hospitals from 2005-2016 for patients with primary varicella infection. Results There were 2717 admissions with primary varicella infection. The average annual number of admissions was 226 for an incidence of 4.87/100,000. Average length of stay (ALOS) was 5-days. Sixty-two (2.5%) patients required intensive-care with an ALOS of 26-days. The most common secondary diagnoses were cellulitis, volume-depletion and streptococcal infection. The number of admissions due to streptococcal infection and cellulitis significantly increased over the period. Conclusion Chickenpox places a consistent burden on Irish healthcare, accounting for in excess of 1100 acute and 160 intensivecare bed days annually. This study adds weight to the argument that universal varicella vaccine should be considered and provides baseline epidemiology to determine vaccine effectiveness in the future.


Assuntos
Varicela/complicações , Hospitalização/estatística & dados numéricos , Adolescente , Varicela/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Irlanda/epidemiologia , Masculino , Estudos Retrospectivos
10.
Dermatol Ther ; 32(6): e13087, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31515892

RESUMO

Herpes Zoster (HZ), caused by the reactivation of the latent Varicella Zoster Virus infection is a disease that may rarely develop in childhood. HZ is considered to be a disease of adult, but recent reports show an increase in the number of cases in childhood. This study was designed to evaluate the demographic and clinical features of children with HZ. Data from patients under 18 years of age that were diagnosed with HZ at two different dermatology outpatient clinics were retrospectively evaluated between October 2012 and December 2018. Out of 60 cases enrolled in the study, 37 were male and 23 were female. The mean age of patients was 8 ± 4.93 years. Of all the cases, 46 had a history of chickenpox. Three patients had been vaccinated against chickenpox. Itching, observed in 48 subjects, was the most common symptom, while 38 subjects complained of pain. Acyclovir was prescribed as antiviral therapy in 33 cases. None of the cases showed any complication. HZ may occur in healthy children without any immunosuppression, too. Pain in children is less common than in adults whereas, itching is more frequent. Complications are rare in these subjects.


Assuntos
Antivirais/administração & dosagem , Vacina contra Varicela/administração & dosagem , Varicela/complicações , Herpes Zoster/epidemiologia , Aciclovir/administração & dosagem , Adolescente , Criança , Pré-Escolar , Feminino , Herpes Zoster/diagnóstico , Humanos , Lactente , Masculino , Estudos Retrospectivos
11.
Rev Paul Pediatr ; 37(4): 510-515, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31291442

RESUMO

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.


Assuntos
Varicela/complicações , Osteomielite/diagnóstico , Osteomielite/virologia , Feminino , Humanos , Lactente , Costelas
12.
J Clin Neurosci ; 68: 146-150, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31327588

RESUMO

We aimed to identify the most common causes of acute ataxia in children in the era of widespread varicella vaccination and the yield of commonly used diagnostic work-up. This retrospective study reviewed the medical records of children who presented with ataxia of less than 72 h duration, over the last 12 years. Associated signs and symptoms, laboratory, EEG and neuroimaging studies, final diagnosis and clinical findings at discharge and during follow-up were studied. A total of 58 patients (35 boys, 23 girls), mean age 4.9 ±â€¯3.8 years, were enrolled. The most common etiology of acute ataxia in our study was post-infectious acute cerebellar ataxia (50%). Children diagnosed with post-infectious acute cerebellar ataxia were significantly younger (3.48 ±â€¯2.23 vs. 6.5 ±â€¯3.1 years, p = 0.01), as compared with children diagnosed with infection and acute disseminated encephalomyelitis. 86% of children with post-infectious cerebellar ataxia were younger than 5 years of age. The abnormality yield of work-up studies performed in our cohort was 39% for lumbar puncture, 36% for EEG, 7% for CT scan. MRI was done in children who showed extra cerebellar signs, when vascular or demyelinating diseases were suspected and in children with prolonged symptoms and was abnormal in 8 (14%) children. We conclude that post-infectious acute cerebellar ataxia remains the most common cause of acute ataxia in children. Although lumbar puncture and neuroimaging should be considered in all children with acute cerebellar ataxia, younger children with a history of previous viral illness and no extra cerebellar signs and symptoms may benefit from watchful waiting.


Assuntos
Ataxia Cerebelar/diagnóstico , Ataxia Cerebelar/etiologia , Adolescente , Varicela/complicações , Varicela/epidemiologia , Varicela/prevenção & controle , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos , Vacinação
13.
Pan Afr Med J ; 33: 19, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31312335

RESUMO

Varicella is a viral disease whose cause is poorly known in Burkina Faso. The aim of this study is to describe varicella features in the department of infectious diseases at the Yalgado Ouedraogo University Hospital. We here report a series of 19 cases of patients hospitalized between the 1stJanuary 2005 and 31st December 2014. The study included all patients with complete and workable medical records who received a positive diagnosis of varicella. The rate of varicella was 6.2%, accounting for 14.6% of febrile rash. It had been more common in 2011, from January to March. The average age was 19 years and half of the patients were aged between 6 and 30 years. Comorbidities were dominated by HIV infection and herpes. Clinically, fever and pruritus were the typical symptoms and vesicles were the most common type of eruption. On admission, the main complications included pulmonary, hematological and cutaneous complications. The median duration of hospitalization was 5 days, ranging between 0 and 13 days. The main treatments were based on antiviral drugs in 9 cases, antipyretic drugs in 19 cases, topic drugs in 17 cases and antihistamines in 11 cases. Out of 19 cases of varicella, 14 were cured and 2 died, including 1 adult out of 10 and 1 child out of 9. Varicella is usually a benign disease. It can be fatal in adults and children with severe complications.


Assuntos
Varicela/epidemiologia , Infecções por HIV/epidemiologia , Hospitalização/estatística & dados numéricos , Adolescente , Adulto , Burkina Faso , Varicela/complicações , Varicela/mortalidade , Criança , Feminino , Febre/epidemiologia , Febre/etiologia , Hospitais Universitários , Humanos , Tempo de Internação , Masculino , Prurido/epidemiologia , Prurido/etiologia , Adulto Jovem
14.
Rev. clín. med. fam ; 12(2): 97-100, jun. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-186263

RESUMO

La varicela es una enfermedad propia de la infancia; su presentación en adultos es muy poco frecuente y suele asociarse a cuadros de mayor gravedad y afectación sistémica. Se presenta como un exantema generalizado de diseminación centrípeta, pruriginoso y pleomórfico, de predominio facial y troncular, que respeta las extremidades. La neumonía es la complicación extracutánea más frecuente y la principal causa de hospitalización en este grupo etario. La afectación palmo-plantar es excepcional y suele estar asociada a enfermedad diseminada en pacientes con importante comorbilidad o algún tipo inmunosupresión. Presentamos el caso de un paciente de 71 años que presenta enfermedad varicelosa diseminada, caracterizada por neumonía y afectación palmo-plantar, en el contexto de tratamiento con corticoides


Varicella is a childhood disease; it occurs very rarely in adults, usually associated with more severe cases and systemic involvement. It presents as a generalized rash of centripetal spread, pruritic and pleomorphic, occurring in the face and trunk but not in the limbs. Pneumonia is the most frequent extracutaneous complication and the leading cause of hospitalization among this age group. Palmoplantar involvement is uncommon, usually associated with disseminated disease in patients with significant comorbidity or some kind of immunosuppression. We present the case of a 71-year-old patient with disseminated varicella infection, characterized by pneumonia and palmoplantar involvement, and treated with corticosteroids


Assuntos
Humanos , Masculino , Idoso , Varicela/diagnóstico , Pneumonia/diagnóstico , Eczema Disidrótico/etiologia , Varicela/complicações , Exantema/etiologia , Herpesvirus Humano 3/patogenicidade , Aciclovir/uso terapêutico
16.
BMJ Case Rep ; 12(4)2019 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-30948409

RESUMO

Varicella gangrenosum is a gangrenous ulceration of varicella lesions involving the skin and soft tissues of the body. The term was coined more than 100 years ago. This occurs due to superimposed bacterial infection. The presentation of primary varicella in adults is more severe with catastrophic systemic complications as compared with children. These complications include necrotising fasciitis, disseminated intravascular coagulation, wet/dry gangrene and death, as was seen in our case. Survival is dependent on early diagnosis and treatment. Adequate antibiotic treatment and particularly early radical surgical debridement should be the cornerstone of management. Less than 10 such cases are reported in the literature.


Assuntos
Varicela/complicações , Fasciite Necrosante/etiologia , Gangrena/etiologia , Infecções Estafilocócicas/complicações , Fasciite Necrosante/diagnóstico , Evolução Fatal , Gangrena/diagnóstico , Doenças dos Genitais Masculinos/etiologia , Herpesvirus Humano 3/isolamento & purificação , Humanos , Extremidade Inferior/patologia , Masculino , Infecções Estafilocócicas/diagnóstico , Staphylococcus aureus/isolamento & purificação , Adulto Jovem
20.
Med Mal Infect ; 49(1): 1-8, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29789159

RESUMO

Despite its benign characteristics, chickenpox is a childhood disease responsible for complications and deaths, particularly in the high-risk population. VariZIG®, not commercialized in France, is a good alternative for seronegative individuals exposed to the virus and not eligible for vaccination. The efficacy of routine vaccination has been demonstrated with a decrease in chickenpox incidence and with the development of herd immunity. Over time, the protective antibody titer of vaccinated people decreases and can be maintained by two doses of the vaccine. A tetravalent measles-mumps-rubella-chickenpox vaccine, used in the United States, has a good tolerability in spite of the occurrence of fever and febrile seizures. Routine vaccination would contribute to make savings in France, by reducing direct and indirect costs of chickenpox.


Assuntos
Varicela , Varicela/complicações , Varicela/economia , Varicela/epidemiologia , Varicela/prevenção & controle , Vacina contra Varicela/uso terapêutico , Criança , França/epidemiologia , Hospitalização/economia , Hospitalização/estatística & dados numéricos , Humanos , Esquemas de Imunização , Vacina contra Sarampo-Caxumba-Rubéola/uso terapêutico , Estados Unidos/epidemiologia , Vacinação/economia , Vacinação/métodos , Vacinação/tendências , Vacinas Combinadas/uso terapêutico
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