title: Streptococcus pulmonary empyema after varicella infection in a serologically immunocompetent boy.
abstract: Varicella zoster virus (VZV) is the etiologic agent of varicella, and it remains common among children in Japan due to low vaccination rates. It can cause a variety of serious and life-threatening complications. Generally, the most frequent complication of varicella in healthy children is bacterial superinfection, but empyema after VZV infection is a rare condition. This case report describes a previously healthy 21-month-old boy who attended nursery school with a recent varicella and group A β-hemolytic streptococcus (GABHS) pharyngitis outbreak and who presented with a 7 day history of vesicular rash along with progressive fever. Due to continued mild cough and prolonged fever, however, chest radiography was done, which showed a right pleural effusion. Further computed tomography showed a right pulmonary empyema, and purulent material was drained and eventually grew GABHS. This report hereby describes the development of pleural empyema caused by GABHS after VZV infection in a serologically immunocompetent patient.
authors.affiliation: Department of Pediatrics, Teine Keijinkai Hospital, Sapporo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamaguchi
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Nagumo
authors.forename: Daisuke
authors.initials: D
authors.lastname: Sasaki
authors.forename: Hayato
authors.initials: H
authors.lastname: Aoyagi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kato
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Narita
authors.forename: Takuya
authors.initials: T
authors.lastname: Tamura
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Kosugiyama
authors.forename: Taiji
authors.initials: T
authors.lastname: Nakashima
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Kinugawa
mesh_terms: D002644:Chickenpox / Q000150:complications*; D016724:Empyema, Pleural / Q000209:etiology*; D006801:Humans; D007121:Immunocompetence; D007223:Infant; D008297:Male; D013290:Streptococcal Infections / Q000209:etiology*
keywords: group A β-hemolytic streptococcus; pulmonary empyema; varicella