Department of Dermatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
St. Anna Children's Hospital, Vienna, Austria.
Wien Med Wochenschr. 2021 Mar;171(3-4):61-64. doi: 10.1007/s10354-020-00790-x. Epub 2020 Dec 10.
Varicella-zoster virus (VZV) infection, also known as chickenpox, is a common childhood affliction. Generalized small itchy single-standing vesicles on erythematous skin are typical. Both cutaneous and systemic complications of the VZV infection may commonly occur. A three-year-old girl with a previous history of mild atopic dermatitis presented in our Pediatric Dermatology Clinic in poor general condition, with a skin rash predominantly consisting of generalized large blisters with hypopyon sign and erosions. On a closer look, scattered erythematous papules and vesicles were also visible. A positive Tzanck smear from an intact pinhead-sized vesicle and VZV PCR confirmed the clinical diagnosis of chickenpox. Cultures from hypopyon material revealed Staphylococcus aureus superinfection. We report an exceptional, not-yet described complication of chickenpox with hypopyon-forming superinfection in an atopic child. In addition, our case nicely underscores the necessity of early VZV vaccination, which has been available and recommended now for more than 10 years in pediatric vaccination programs to avoid severe complications.
水痘-带状疱疹病毒（VZV）感染，又称水痘，是一种常见的儿童疾病。其典型表现为全身性、单发、瘙痒性、小水疱，常伴有皮肤和全身并发症。我们皮肤科诊所接诊了一名 3 岁女童，她曾患有轻度特应性皮炎，一般情况较差，全身皮疹主要表现为广泛分布的大疱，伴前房积脓和糜烂。仔细观察还可见散在的红斑性丘疹和水疱。从一个未受损的针头大小水疱中进行的 Tzanck 涂片检查和 VZV PCR 均证实了水痘的临床诊断。前房积脓的培养结果显示金黄色葡萄球菌合并感染。我们报告了一例特应性儿童水痘合并前房积脓的、尚未描述的罕见并发症。此外，我们的病例很好地强调了早期接种 VZV 疫苗的必要性，该疫苗在儿科疫苗接种计划中已应用和推荐超过 10 年，以避免严重的并发症。
