Fatal varicella pneumonia in an unvaccinated child with Down Syndrome: a case report

Diletta Valentini,Chiara Di Camillo,Michaela Veronika Gonfiantini,Rita De Vito,Simona Bianchi,Anna Chiara Vittucci,Alberto Villani

doi:10.1186/s13052-016-0312-1

Abstract

BackgroundVaricella is an acute infectious disease common during childhood. It has mostly an uncomplicated course in early childhood. Neverthless, it may result in severe complications, especially in particular age groups and clinical conditions. Down Syndrome represents a risk factor for developing complications, because of the frequent comorbidities and their immunodeficiency.Case presentationA 2-year-old white Caucasian female affected by Down Syndrome was referred to our hospital for cardiac arrest in course of varicella disease. After cardiopulmonary resuscitation and stabilization, her clinical conditions didn’t improve and she developed a massive pulmonary hemorrage, which led her to exitus.ConclusionsMortality due to varicella infection is rare, but it is more common in subjects with immune deficit or chronic pathologies, and in particular age-groups. The importance of the vaccine for preventable infectious diseases is stressed in this paper, in which we present a case of death in an unvaccinated cardiopathic child with Down Syndrome affected by varicella.

Highlights

Varicella is an acute infectious disease common during childhood
Case presentation A 2-years-old white Caucasian female affected by Down Syndrome (DS) and surgically corrected at 3 months of age for a subaortic intraventricular defect (IVD), with a history of 2 episodes of pneumonia, was admitted in the emergency room of our hospital due to a cardiac arrest during her varicella illness
At 4 o’clock she began to show signs of a generalized hypotonia and she was taken to our hospital by her parents, where she arrived in cardiac arrest

Summary

Background

Exanthematous, highly infectious disease, that most commonly occurs in childhood. Case presentation A 2-years-old white Caucasian female affected by Down Syndrome (DS) and surgically corrected at 3 months of age for a subaortic intraventricular defect (IVD), with a history of 2 episodes of pneumonia, was admitted in the emergency room of our hospital due to a cardiac arrest during her varicella illness. She had never been vaccinated up to the moment, that’s why she contracted the disease from her sister. There are interstitial pneumonitis, diffuse necrosis and hemorrhage in the pulmonary parenchyma (Fig. 2)

Conclusions

VZV IgG negative