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Abstract
La varicelle peut se compliquer, même à distance de la phase aigue, de graves lésions cérébrales à l’origine d’handicaps. Nous présentons le cas d’un garçon de 4 ans qui avait présenté un coma non fébrile dans les suites d’une varicelle. Le scanner en urgence a montré des lésions ischémiques bilatérales des noyaux gris centraux. L’électrophorèse de l’hémoglobine, le bilan biologique et hématologique étaient négatifs. La varicelle peut se compliquer d’ischémie cérébrale. La surveillance neurologique des enfants atteints de varicelle est requise aussi bien en phase aigue qu’à distance de la maladie. La seule prévention repose sur une bonne couverture vaccinale.
Mots clés : varicelle ; surveillance neurologique ; ischémie cérébrale.
ABSTRACT
Chickenpox can be complicated by severe cerebral ischemic lesions, that secondarily cause serious handicap. We report the case of a four years old child, who presented a coma without fever some time after having contracted chickenpox. The emergency CT scan showed bilateral ischemic lesions of the basal ganglia. Hemoglobin electrophoresis, biological and haematological tests were negative. Chickenpox may be complicated by cerebral ischemia. Neurological monitoring of children with chickenpox is required. The only prevention is based on good vaccine coverage.
Key words: chickenpox, neurological monitoring; cerebral ischemia.
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References
- 11ème Conférence de consensus en thérapeutique anti infectieuse de la SPILF. « Prise en charge des infections à VZV ». Méd Mal Infect. 1998 ; 28 : 1-8
- Donahue JG, Kieke BA, Yih WK, Berger NR and al. Varicella vaccination and ischemic stroke in children: Is there an association? Pediatrics. 2009 Feb;123(2):e228-34.
- Gómez-Gosálvez FA, Menor-Serrano F and al. Ischemic stroke secondary to post varicella angiopathy in a 3 year old male. Rev Neurol. 2003 May 16-31; 36(10):930-2
- Gilden D, Cohrs RJ, Mahalingam R, Nagel MA. Varicella zoster virus vasculopathies: diverse clinical manifestations, laboratory features, pathogenesis, and treatment. Lancet Neurol. 2009 Aug; 8(8):731-40.
- Askalan R, Laughlin S, Mayank S and al. Chickenpox and stroke in childhood: a study of frequency and causation. Stroke. 2001 Jun;32(6):1257-62.
- Gilden DH, Lipton HL and al. Two patients with unusual forms of varicella-zoster virus vasculopathy. N Engl J Med. 2002 Nov 7;347(19):1500-3.
- Bozzola E, Tozzi AE and al. Neurological complications of varicella in childhood: case series and a systematic review of the literature. Vaccine. 2012 Aug 24;30(39):5785-90.
References
11ème Conférence de consensus en thérapeutique anti infectieuse de la SPILF. « Prise en charge des infections à VZV ». Méd Mal Infect. 1998 ; 28 : 1-8
Donahue JG, Kieke BA, Yih WK, Berger NR and al. Varicella vaccination and ischemic stroke in children: Is there an association? Pediatrics. 2009 Feb;123(2):e228-34.
Gómez-Gosálvez FA, Menor-Serrano F and al. Ischemic stroke secondary to post varicella angiopathy in a 3 year old male. Rev Neurol. 2003 May 16-31; 36(10):930-2
Gilden D, Cohrs RJ, Mahalingam R, Nagel MA. Varicella zoster virus vasculopathies: diverse clinical manifestations, laboratory features, pathogenesis, and treatment. Lancet Neurol. 2009 Aug; 8(8):731-40.
Askalan R, Laughlin S, Mayank S and al. Chickenpox and stroke in childhood: a study of frequency and causation. Stroke. 2001 Jun;32(6):1257-62.
Gilden DH, Lipton HL and al. Two patients with unusual forms of varicella-zoster virus vasculopathy. N Engl J Med. 2002 Nov 7;347(19):1500-3.
Bozzola E, Tozzi AE and al. Neurological complications of varicella in childhood: case series and a systematic review of the literature. Vaccine. 2012 Aug 24;30(39):5785-90.