Abstract
Chickenpox is a viral disease characterized by vesicular skin
eruptions. It is commonly encountered during childhood and
generally follows a benign course without complications. The
most common complications are secondary bacterial skin
infections ranging from superficial impetigo to subcutaneous
abscess. Musculoskeletal complications like septic arthritis and
osteomyelitis are rarely seen. In any child complaining of bone
pain or arthralgia, during or after healing of varicella eruptions,
the possibility of osteomyelitis and septic arthritis should be
kept in mind. Early diagnosis is important because with the use
of appropriate antibiotics, the need for surgical interventions and
sequela can be prevented. Here, we present a case of subacute
osteomyelitis that needed antibiotic and surgical treatment, whose
initial symptom was right ankle pain that developed after three
weeks of chicken pox.
Keywords
References
- Mueller NH, Gilden DH, Cohrs RJ, Mahalingam R, Nagel MA.Varicella zoster virus infection: clinical features, molecular pathogenesis of disease, and latency. Neurol Clin 2008;26:675-97, doi: 10.1016/j.ncl.2008.03.011.
- Choo PW, Donahue JG, Manson JE, Platt R. The epidemiology of varicella and its complications. J Infect Dis 1995;172:706-12.
- Aebi C, Ahmed A, Ramilo O. Bacterial complications of primary varicella in childdren. Clin Infect Dis 1996;23:698705.
- Koturoglu G, Kurugöl Z, Çetin N, et al. Complications of varicella in healthy children in Izmir, Turkey. Pediatrics International 2005;47:296-9.
- Ziebold C, von Kries R, Lang R, Weigl J, Schmitt HJ. Severe complications of varicella in previously healthy children in Germany: a 1-year survey. Pediatrics 2001;108: E79.
- Laxer RM, Lindsey CB. Arthritis related to infection. In: Cassidy JT, Petty RE, Laxer RM, Lindsey CB, editors. Textbook of Pediatric Rheumatology. 6th ed. Philadelphia: Saunders, 2011:559-78.
- Dinleyici EC, Kurugol Z, Turel O, et al. The epidemiology and economic impact of varicella-related hospitalizations in Turkey from 2008 to 2010: a nationwide survey during the prevaccine era (VARICOMP study). Eur J Pediatr 2012;171:81725. doi: 10.1007/s00431-011-1650-z.
- Özdemir H, Çandır MO, Karbuz A, et al. Chickenpox complications, incidence and financial burden in previously healthy children and those with an underlying disease in Ankara in the pre-vaccination period. Turk J Pediatr 2011;53:614-25.
- Borgen L, Haakonsen MO, Gudmundsen TE, Solheim D, Stensvold K. Acute osteomyelitis as a complication of varicella. Acta Radiol 2005;46:652-6.
- Bozzola E, Krzystofiak A, Lancella L, Quondamcarlo A, Villani A. A severe case of paediatric group A streptococcal osteomyelitis in varicella. Infection 2012;40:343-5. doi: 10.1007/s15010-011-0195-4.
- McCarthy JJ, Dormans JP, Kozin SH, et al. Musculoskeletal infections in children: basic treatment principles and recent advancements. J Bone Joint Surg Am 2004; 86:850-63.
- Kaplan PA, Helms CA, Dussault R, Anderson MW, Major NM. Muskuloskeletal infections. In: Musculoskeletal MRI. 1st ed. Philadelphia: Saunders: 2001.
- Cottias P, Tomeno B, Anract P, Vinh TS, Forest M. Subacute osteomyelitis presenting as a bone tumour. A review of 21 cases. Int Orthop 1997;21:243-8.
- Shimose S, Sugita T, Kubo T, Matsuo T, Nobuto H, Ochi M. Differential diagnosis between osteomyelitis and bone tumors. Acta Radiol 2008;49:928-33. doi: 10.1080/02841850802241809
- Bittmann S. Bacterial osteomyelitis after varicella infection in children. J Bone Miner Metab 2004;22:283-5.
- Hamdy RC, Lawton L, Carey T, Wiley J, Marton D. Subacute hematogenous osteomyelitis: are biopsy and surgery always indicated? J Pediatr Orthop 1996;16:220-3
Abstract
Suçiçeği, çocukluk çağında sık görülen ve genellikle komplikasyonsuz seyreden, veziküler döküntüler ile karakterize viral bir hastalıktır. En sık görülen komplikasyonlar yüzeyel impetigodan, subkütan abseye kadar değişebilen sekonder bakteriyel deri infeksiyonlarıdır. Septik artrit ve osteomyelit gibi muskuloskeletal komplikasyonlar ise çok nadir görülen komplikasyonlardır. Suçiçeği sırasında veya döküntüler iyileştikten sonra eklem veya kemik ağrısından şikayet eden tüm çocuklarda osteomyelit veya septik artrit olasılığı akılda tutulmalıdır. Uygun antibiyotik tedavisi ile cerrahi müdahale veya sekel oranı belirgin azaldığı için erken tanı önemlidir. Bu yazıda suçiçeğinden üç hafta sonra ayak bileği ağrısı şikayeti gelişen ve subakut osteomyelit tanısı konularak antibiyotik ve cerrahi tedavi uygulanan olgu sunulmuştur
Keywords
References
- Mueller NH, Gilden DH, Cohrs RJ, Mahalingam R, Nagel MA.Varicella zoster virus infection: clinical features, molecular pathogenesis of disease, and latency. Neurol Clin 2008;26:675-97, doi: 10.1016/j.ncl.2008.03.011.
- Choo PW, Donahue JG, Manson JE, Platt R. The epidemiology of varicella and its complications. J Infect Dis 1995;172:706-12.
- Aebi C, Ahmed A, Ramilo O. Bacterial complications of primary varicella in childdren. Clin Infect Dis 1996;23:698705.
- Koturoglu G, Kurugöl Z, Çetin N, et al. Complications of varicella in healthy children in Izmir, Turkey. Pediatrics International 2005;47:296-9.
- Ziebold C, von Kries R, Lang R, Weigl J, Schmitt HJ. Severe complications of varicella in previously healthy children in Germany: a 1-year survey. Pediatrics 2001;108: E79.
- Laxer RM, Lindsey CB. Arthritis related to infection. In: Cassidy JT, Petty RE, Laxer RM, Lindsey CB, editors. Textbook of Pediatric Rheumatology. 6th ed. Philadelphia: Saunders, 2011:559-78.
- Dinleyici EC, Kurugol Z, Turel O, et al. The epidemiology and economic impact of varicella-related hospitalizations in Turkey from 2008 to 2010: a nationwide survey during the prevaccine era (VARICOMP study). Eur J Pediatr 2012;171:81725. doi: 10.1007/s00431-011-1650-z.
- Özdemir H, Çandır MO, Karbuz A, et al. Chickenpox complications, incidence and financial burden in previously healthy children and those with an underlying disease in Ankara in the pre-vaccination period. Turk J Pediatr 2011;53:614-25.
- Borgen L, Haakonsen MO, Gudmundsen TE, Solheim D, Stensvold K. Acute osteomyelitis as a complication of varicella. Acta Radiol 2005;46:652-6.
- Bozzola E, Krzystofiak A, Lancella L, Quondamcarlo A, Villani A. A severe case of paediatric group A streptococcal osteomyelitis in varicella. Infection 2012;40:343-5. doi: 10.1007/s15010-011-0195-4.
- McCarthy JJ, Dormans JP, Kozin SH, et al. Musculoskeletal infections in children: basic treatment principles and recent advancements. J Bone Joint Surg Am 2004; 86:850-63.
- Kaplan PA, Helms CA, Dussault R, Anderson MW, Major NM. Muskuloskeletal infections. In: Musculoskeletal MRI. 1st ed. Philadelphia: Saunders: 2001.
- Cottias P, Tomeno B, Anract P, Vinh TS, Forest M. Subacute osteomyelitis presenting as a bone tumour. A review of 21 cases. Int Orthop 1997;21:243-8.
- Shimose S, Sugita T, Kubo T, Matsuo T, Nobuto H, Ochi M. Differential diagnosis between osteomyelitis and bone tumors. Acta Radiol 2008;49:928-33. doi: 10.1080/02841850802241809
- Bittmann S. Bacterial osteomyelitis after varicella infection in children. J Bone Miner Metab 2004;22:283-5.
- Hamdy RC, Lawton L, Carey T, Wiley J, Marton D. Subacute hematogenous osteomyelitis: are biopsy and surgery always indicated? J Pediatr Orthop 1996;16:220-3