Varicella cellulitis in children (personal experience)

Abstract

The frequency of complications with varicella is 5-30%, and their level is much higher in patients with immunodeficiencies.In 8-50% of hospitalized children with varicella virus infection develop skin and soft tissue complications such as cellulitis, lymphadenitis,abscess, hysteria, toxicoderma. They are located on vulnerable parts of the body against the background of a state of anergy in a sickchild, which is caused by the varicella virus. The aim is highlight clinical and diagnostic features and methods of treatment of varicellavirus cellulitis in children based on own experience and according to literature sources. The high frequency of complications isassociated with untimely detection of signs of inflammation and untimely treatment in case of secondary flora joining. The mainetiological factors of superinfection are -hemolytic streptococcus group A and staphylococcus aureus. Recently, cellulitis of thesubcutaneous tissue is one of the most serious complications in patients with varicella virus infection. The clinical picture of thiscomplication includes local and general manifestations. Local symptoms are accompanied by pronounced redness in the affectedarea, a significant increase in tissue volume due to swelling, intense, throbbing pain that worsens with touch or movement, thepresence of purulent secretions from the affected area, compaction or softening of tissues at the site of the lesion, local hyperthermia.Treatment of varicella cellulitis involves a wide range of measures, which include: antibiotic therapy, drainage of purulent foci,symptomatic treatment, local treatment, supportive therapy, physiotherapy, observation and control. Before determining the optimalantibiotic, it is important to take into account the regional characteristics of the resistance of microorganisms and information aboutthe typical causative agents of varicella cellulitis. Broad-spectrum antibiotics such as amoxicillin with clavulanic acid, ceftriaxone,clindamycin, or vancomycin are usually used for treatment. So, the main etiological factors causing complications in the form ofnecrotic cellulitis on the background of varicella virus are β-hemolytic streptococcus group A and Staphylococcus aureus. Diagnosisof varicella cellulitis includes a set of examination methods to confirm the diagnosis: daily examination of the child's body surface forinflammatory foci. The optimal treatment tactic is combined therapy (surgical and conservative treatment). Vaccination is recommendedfor children who are in risk groups - patients with oncology who receive cytostatics, corticosteroids; children with congenital andacquired immunodeficiencies.