Varicella cellulitis in children (personal experience)

Annotation. The frequency of complications with varicella is 5-30%, and their level is much higher in patients with immunodeficiencies. In 8-50% of hospitalized children with varicella virus infection develop skin and soft tissue complications such as cellulitis, lymphadenitis, abscess, hysteria, toxicoderma. They are located on vulnerable parts of the body against the background of a state of anergy in a sick child, which is caused by the varicella virus. The aim is highlight clinical and diagnostic features and methods of treatment of varicella virus cellulitis in children based on own experience and according to literature sources. The high frequency of complications is associated with untimely detection of signs of inflammation and untimely treatment in case of secondary flora joining. The main etiological factors of superinfection are β-hemolytic streptococcus group A and staphylococcus aureus. Recently, cellulitis of the subcutaneous tissue is one of the most serious complications in patients with varicella virus infection. The clinical picture of this complication includes local and general manifestations. Local symptoms are accompanied by pronounced redness in the affected area, a significant increase in tissue volume due to swelling, intense, throbbing pain that worsens with touch or movement, the presence of purulent secretions from the affected area, compaction or softening of tissues at the site of the lesion, local hyperthermia. Treatment of varicella cellulitis involves a wide range of measures, which include: antibiotic therapy, drainage of purulent foci, symptomatic treatment, local treatment, supportive therapy, physiotherapy, observation and control. Before determining the optimal antibiotic, it is important to take into account the regional characteristics of the resistance of microorganisms and information about the typical causative agents of varicella cellulitis. Broad-spectrum antibiotics such as amoxicillin with clavulanic acid, ceftriaxone, clindamycin, or vancomycin are usually used for treatment. So, the main etiological factors causing complications in the form of necrotic cellulitis on the background of varicella virus are β-hemolytic streptococcus group A and Staphylococcus aureus. Diagnosis of varicella cellulitis includes a set of examination methods to confirm the diagnosis: daily examination of the child's body surface for inflammatory foci. The optimal treatment tactic is combined therapy (surgical and conservative treatment). Vaccination is recommended for children who are in risk groups – patients with oncology who receive cytostatics, corticosteroids; children with congenital and acquired immunodeficiencies.