title: Streptococcal toxic shock syndrome complicating varicella in children.
abstract: 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.
authors.affiliation: Department of Pediatrics, National Cheng Kung University Medical Center, Tainan, Taiwan.
authors.forename: Y J
authors.initials: YJ
authors.lastname: Yang
authors.forename: C C
authors.initials: CC
authors.lastname: Liu
authors.forename: S M
authors.initials: SM
authors.lastname: Wang
authors.forename: C C
authors.initials: CC
authors.lastname: Huang
authors.forename: J J
authors.initials: JJ
authors.lastname: Wu
mesh_terms: D002644:Chickenpox / Q000150:complications*; D002675:Child, Preschool; D006801:Humans; D008297:Male; D012772:Shock, Septic / Q000209:etiology*; D013290:Streptococcal Infections / Q000209:etiology*; D013297:Streptococcus pyogenes