Yang Y J, Liu C C, Wang S M, Huang C C, Wu J J
Department of Pediatrics, National Cheng Kung University Medical Center, Tainan, Taiwan.
J Formos Med Assoc. 1997 Sep;96(9):749-53.
The most common complication in children with varicella is cutaneous superimposed infection with pyogenic bacteria. Group A beta-hemolytic streptococci, which are known to cause life-threatening infections in both previously healthy children and those with underlying diseases, are the most frequently associated pathogens. A newly recognized disease, called streptococcal toxic shock syndrome, is associated with severe morbidity and mortality. We report a 3-year-old boy with a diagnosis of this syndrome who presented with increasing fever, vomiting, and lethargy 7 days after the development of a classic varicella skin lesion. In spite of aggressive fluid supply, administration of inotropic agents, and cardiopulmonary resuscitation, a rapidly deteriorating clinical course led to death 4 hours after hospitalization. This is the first report of this association in Taiwan. Pediatricians evaluating children with varicella must be mindful of the potential for Group A beta-hemolytic streptococcal infection.
水痘患儿最常见的并发症是皮肤继发化脓性细菌感染。A组β溶血性链球菌在既往健康的儿童和患有基础疾病的儿童中均可引起危及生命的感染，是最常相关的病原体。一种新认识的疾病，称为链球菌中毒性休克综合征，与严重的发病率和死亡率相关。我们报告一名3岁男孩诊断为此综合征，在出现典型水痘皮肤损害7天后出现发热、呕吐和嗜睡加重。尽管积极补液、给予血管活性药物并进行心肺复苏，但临床病程迅速恶化，住院4小时后死亡。这是台湾地区关于这种关联的首例报告。评估水痘患儿的儿科医生必须注意A组β溶血性链球菌感染的可能性。
