Orbital cellulitis secondary to primary varicella zoster infection in a child: a rare but serious complication
DOI:
https://doi.org/10.18203/2320-6012.ijrms20260989Keywords:
Varicella, Orbital cellulitis, Secondary bacterial infection, Pediatric infection, Varicella zoster virus, AcyclovirAbstract
Varicella zoster virus (VZV) infection is generally a self-limiting childhood illness; however, secondary bacterial complications may result in significant morbidity. Orbital cellulitis is a rare but vision-threatening complication of varicella, usually arising from bacterial superinfection following disruption of the cutaneous barrier. We report the case of a 7-year-old child who developed unilateral orbital cellulitis three days after the onset of primary varicella infection. Prompt recognition and aggressive combined antiviral and broad-spectrum intravenous antibiotic therapy resulted in complete clinical recovery. This case highlights the importance of early identification of red-flag symptoms in varicella and underscores the need for vigilant monitoring for invasive bacterial complications.
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References
Gershon AA. Varicella-zoster virus infections. N Engl J Med. 2007;356(7):673-84.
Arvin AM. Varicella-zoster virus. Clin Microbiol Rev. 1996;9(3):361-81. DOI: https://doi.org/10.1128/CMR.9.3.361
Choo PW, Donahue JG, Manson JE, Platt R. The epidemiology of varicella and its complications. Pediatrics. 1995;95(4):575-81.
Brogan PA, Raffles A. Varicella-associated invasive group A streptococcal disease. Arch Dis Child. 2000;83(4):386-90.
Chandler JR, Langenbrunner DJ, Stevens ER. The pathogenesis of orbital complications in acute sinusitis. Laryngoscope. 1970;80(9):1414-28. DOI: https://doi.org/10.1288/00005537-197009000-00007
Ferguson MP, McNab AA. Orbital cellulitis. Ophthalmology. 1999;106(12):2413-8.
American Academy of Pediatrics. Red Book: 2021 Report of the Committee on Infectious Diseases. 32nd ed. Itasca, IL: AAP. 2021.
Klein NP, Bartlett J, Fireman B, Rowhani-Rahbar A, Baxter R. Varicella and invasive bacterial disease. Pediatrics. 2011;127(3):e678-85.
Donahue SP, Schwartz G. Preseptal and orbital cellulitis. Pediatr Clin North Am. 2003;50(2):329-42.
Wald ER. Periorbital and orbital infections. Pediatr Rev. 2004;25(9):312-9. DOI: https://doi.org/10.1542/pir.25-9-312
Wong SJ, Levi J. Management of pediatric orbital cellulitis: A systematic review. Int J Pediatr Otorhinolaryngol. 2018 Jul;110:123-9. DOI: https://doi.org/10.1016/j.ijporl.2018.05.006
Dunkle LM, Arvin AM, Whitley RJ, Rotbart HA, Feder Jr HM, Feldman S, et al. A controlled trial of acyclovir for chickenpox. J Pediatr. 1991;325(22):1539-44. DOI: https://doi.org/10.1056/NEJM199111283252203
Kimberlin DW. Antiviral therapy for varicella-zoster virus infections. J Infect Dis. 2001;183(1):S60-5.
Heininger U. Varicella complications. Pediatr Infect Dis J. 2006;25(9):846-7.
Gershon AA, Breuer J, Cohen JI, Randall JC, Michael DG, Don G, et al. Varicella-zoster virus infection. Nat Rev Dis Primers. 2015;1:15016. DOI: https://doi.org/10.1038/nrdp.2015.16
Shapiro ED, Vazquez M, Esposito D, Nancy H, Sharon PS, James D, et al. Effectiveness of two-dose varicella vaccination. Pediatrics. 2011;128(2):e365-73.
Leung J, Broder KR, Marin M. Severe varicella in persons vaccinated with varicella vaccine (breakthrough varicella): a systematic literature review. Expert Rev Vaccines. 2017;16(4):391-400. DOI: https://doi.org/10.1080/14760584.2017.1294069
Pappas DE, Hendley JO. Orbital cellulitis in children. Curr Opin Pediatr. 2018;30(1):126-30.
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