Varicella-related hospitalizations in children - case series in a secondary hospital

Abstract

Introduction: Chickenpox is a common infectious disease in childhood. Although generally considered a benign and selflimited disease, it can cause serious complications. The aim of this study was to characterize hospitalizations due to varicella and its complications.

Methods: Retrospective analysis of medical records of children hospitalized at the Paediatric ward due to varicella between 01.01.2000 and 31.12.2012.

Results: During this 13 years’period, 105 children were admitted for chickenpox. Median age was 22 months (1day to 10 years);51,4% were female. The seasonal incidence was highest from April to June. No child had received the varicella vaccine. Complications associated with varicella were the most common reason for hospitalization (76%), including skin infections (56.8%), respiratory (14.8%) and neurologic (14.8%) complications. The remaining children were hospitalized by the presence of risk factors (age, congenital varicella, immunosuppression) or the severity of the symptoms. Acyclovir was given to 68 children (65%), of which 20 had the treatment begun before hospitalization. The average length of stay was 4.5 days. Three children were transferred to a tertiary hospital, one due to scalded skin syndrome, another one with otomastoiditis requiring surgery and the last as a result of pneumonia with pleural effusion. A child with encephalitis developed sequelae.

Discussion: Chickenpox can cause serious complications especially in children with risk factors. In the period of study, it accounted for 0.7% of admissions. The most frequent complications were cutaneous, which is in agreement with other studies. This work allowed the revision of the practices of service, particularly questioning the need for inpatient admissions in the group without complications.