[Varicella associated necrotizing fasciitis in a child].
We present a rare case of necrotizing fasciitis in an 5-year-old infant with preexisting varicella infection. Initially, the patient showed acute pain and swelling of the left thorax with high inflammatory parameters and varicella-specific skin affections. MRT presented diffuse soft tissue swelling of the left chest consistent with necrotizing fasciitis. After aggressive surgical debridement of necrotic tissue and extirpation of axillary lymph nodes, the clinical course improved under appropriate parenteral antimicrobial therapy using penicillin and clindamycin. In conclusion, necrotizing fasciitis should be suspected in any child with a history of varicella infection and increasing complaints of pain and swelling in an extremity or other body area associated with increasing fever, erythema, lethargy, and irritability. Shock, multiorgan failure, and death will ensue if the diagnosis is not promptly recognized.
Gröger
A
A
Klinik für Plastische Chirurgie, Hand- und Verbrennungschirurgie, Universitätsklinikum, Aachen. agroeger72@hotmail.com
Ulrich
D
D
Unglaub
F
F
Pallua
N
N
D002644:Chickenpox / Q000150:complications* / Q000601:surgery*; D002675:Child, Preschool; D003646:Debridement / Q000379:methods; D004487:Edema / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D019115:Fasciitis, Necrotizing / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D013207:Staphylococcal Skin Infections / Q000175:diagnosis / Q000209:etiology / Q000601:surgery