Yamaguchi Hiroshi, Nagumo Kiyoshi, Sasaki Daisuke, Aoyagi Hayato, Kato Hiroaki, Narita Yoshiaki, Tamura Takuya, Kosugiyama Kiyotaka, Nakashima Taiji, Kinugawa Yoshikazu
Department of Pediatrics, Teine Keijinkai Hospital, Sapporo, Japan.
Pediatr Int. 2014 Aug;56(4):618-21. doi: 10.1111/ped.12300.
Varicella zoster virus (VZV) is the etiologic agent of varicella, and it remains common among children in Japan due to low vaccination rates. It can cause a variety of serious and life-threatening complications. Generally, the most frequent complication of varicella in healthy children is bacterial superinfection, but empyema after VZV infection is a rare condition. This case report describes a previously healthy 21-month-old boy who attended nursery school with a recent varicella and group A β-hemolytic streptococcus (GABHS) pharyngitis outbreak and who presented with a 7 day history of vesicular rash along with progressive fever. Due to continued mild cough and prolonged fever, however, chest radiography was done, which showed a right pleural effusion. Further computed tomography showed a right pulmonary empyema, and purulent material was drained and eventually grew GABHS. This report hereby describes the development of pleural empyema caused by GABHS after VZV infection in a serologically immunocompetent patient.
