Adult varicella zoster infection complicated with streptococcal retrosternal abscess.
A 43-year-old lady with type 2 diabetes mellitus and bronchial asthma presented with varicella zoster infection, dyspnea, and neck fullness. An urgent computed tomography scan revealed a mediastinal abscess with superior vena cava thrombus. Blood, mediastinal pus, and swab from a vesiculopustule on the neck cultured group A beta hemolytic Streptococcus. She recovered with a combination of broad spectrum antimicrobials, antivirals, and surgical drainage. This case illustrates the rare occurrence of mediastinal abscess and acute superior vena cava obstruction caused by group A beta hemolytic Streptococcus complicating adult varicella zoster.
Bin Yap
Felix Boon
FB
Department of Dermatology, Sarawak General Hospital, Jalan Hospital, 93586 Kuching, Sarawak, Malaysia.
Kiung
Sze Ting
ST
D000038:Abscess / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D002644:Chickenpox / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D014645:Herpesvirus 3, Human; D006801:Humans; D008477:Mediastinal Diseases / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D013249:Sternum; D013290:Streptococcal Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D013297:Streptococcus pyogenes
D000900:Anti-Bacterial Agents; D000998:Antiviral Agents