Disseminated intravascular coagulation (DIC) and rhabdomyolysis in fulminant varicella infection--case report and review of the literature.
Primary infection with varicella-zoster virus usually is a mild, self-limiting childhood illness. However, certain rare but potentially life-threatening complications can be associated with the disease. Adults and immunosuppressed patients are at increased risk for these events. We report a case of a patient on chronic immunosuppressants with fulminant varicella infection complicated by rhabdomyolysis and disseminated intravascular coagulation. Mechanisms of muscle damage in viral diseases might be direct invasion of skeletal muscle and/or induction of harmful cytokines. Aggressive fluid therapy, alkalinization of urine and supportive measures correcting electrolyte imbalances, hypothermia and hypoxemia should result in preservation or complete restoration of renal function. Disseminated intravascular coagulation occurs in conjunction with various diseases and may range from mild laboratory abnormalities to fulminant lethal thrombosis and bleeding. Apart from elimination of the causative process therapeutic strategies are still highly disputed.
Hollenstein
U
U
Klinik für Innere Medizin I, Abt. für Infektionen und Chemotherapie, Allgemeines Krankenhaus Wien, Austria.
Thalhammer
F
F
Burgmann
H
H
D000328:Adult; D002644:Chickenpox / Q000150:complications*; D004211:Disseminated Intravascular Coagulation / Q000150:complications*; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy; D012206:Rhabdomyolysis / Q000150:complications*