Abstract
Chicken pox is mostly a benign infection of childhood and is caused by Varicella Zoster Virus which generally does not lead to any serious complication in an immunocompetent host. Severe and potentially lethal complications like varicella pneumonia, encephalitis and acute kidney injury are known entity in adults but are very rare in paediatric age group. We present a case of Acute Kidney Injury (AKI) in the form of tubulointerstitial nephritis induced by varicella infection in a young immunocompetent child with varicella pneumonia.
Highlights
Varicella is mostly a self-limited benign disease with a very high secondary attack rate.[1]
Renal involvement in varicella was first reported by Henoch in 1884.5 Varicella pneumonia with Acute Kidney Injury (AKI) is rare but a dreaded complication which proved fatal in our case
Healthy children are less prone for have serious and potentially lethal complications but multi organ involvement irrespective of immune status is not a rarity in paediatric age group. Similar to this case renal involvement leading to AKI with varicella pneumonia has been described in adults.[7]
Summary
Varicella is mostly a self-limited benign disease with a very high secondary attack rate.[1]. A six year old previously healthy girl child presented on tenth day of illness with classic presentation of chicken pox related post viral pneumonia and AKI. At presentation she was febrile and anuric with altered sensorium and had respiratory distress (Respiratory rate – 36 / minute and SpO2 – 94% with oxygen by mask). Renal functions and electrolytes improved after 57 cycles of peritoneal dialysis with 1.5% of peritoneal fluid She required three antihypertensive medicines to control her blood pressure below 90th percentile. Graded oxygen therapy was instituted and acyclovir along with antibiotics in renal adjusted doses was administered as per hospital policy She did not respond while on ventilator support and succumbed to her illness
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