Varicella complicated by staphylococcal scalded skin syndrome in a 1-month old child

Authors: Maria Vinna N. Crisostomo, Friend Philemon M. Liwanag, Lalaine R. Visitacion and Bryan Edgar K. Guevara

Abstract

Introduction: Varicella is a self-limited infection but may be associated with life-threatening complications. Staphylococcal scalded skin syndrome (SSSS) is one of its rare complications. Herein we report a case of varicella complicated by SSSS in a one-month old child managed with intravenous acyclovir and antibiotics.

Case Summary: A term, 1-month and 20days old girl presented with multiple vesicles on the neck which progressed to the face, trunk and extremities. Three days later, generalized desquamation was noted leaving erythematous moist areas. The mother and other family members had a vesicular eruption 2 weeks prior to appearance of lesions in our patient. Tzank smear revealed multinucleated giant cells. Histopathology revealed subcorneal acantholysis which is consistent with SSSS. Supportive treatment with fluid replacement, intravenous antibiotics and acyclovir, and wound care were provided. Blood transfusions were also done because of anemia and thrombocytopenia. Upon discharge, there was complete resolution of skin lesions and other complications.

Conclusion: Varicella among neonates and infants may have several serious and life-threatening complications. Every physician should have a high index of suspicion for possible complications of this self-limiting infection when it occurs in this age group.

 

Citation

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Keywords

staphylococcal scalded skin syndrome, varicella, multinucleated giant cell, acyclovir

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