Abstract Ref Number = APCP989
A CASE REPORT VARICELLA BULLOSA IN A 4-YEAR-OLD-GIRL
Andy Setiawan,Sheila Hustadi Budiawan
Faculty of medicine Department of Child Health University of Atma Jaya Faculty of medicine, Department of Child Health, University of Atma Jaya, Jakarta
Background : Varicella is one of the most common viral infections among children and is caused by varicella zoster virus. This disease rarely presents as bullae in children. Because of the rarity of this manifestation, it seems worthwhile to bring this case to the attention of physicians.
Case Presentation Summary : A previously healthy 4-year-old girl presented with papulo-vesicular, polymorphic and itchy lesions that started from her body and face before spreading to her extremities. The patient also presented with low grade fever. She hadn’t received any varicella vaccination. Initially, she was diagnosed with varicella and treated with Acyclovir, immune-modulator and antiseptic bathing solution. Five days later, she came back with wide bullous, which developed 2 days prior, and crusted lesions. Physical examination revealed a mildly ill patient with vesicular and crusted lesions spread across her entire body. Large erythematous areas, due to ruptured bullous, were found on her neck, chest, abdomen, and back. An intact bulla was found on her left foot. No evidence of mucosal involvements was discovered. Diagnosis of varicella bullosa was then established. Treatment with acyclovir was continued for 7 days, with signs of improvement. One week after the patient is cured, her sister developed common manifestations of varicella.
Learning Points/Discussion : Varicella bullosa is a benign disease, unlike hemorrhagic varicella. Similar to majority of cases reported, her lesions cleared spontaneously within 2 weeks from their initial onset. The patient was diagnosed with Varicella Bullosa rather than other serious diseases with similar appearance, like Steven Johnson Syndrome or Staphylococcal Scalded Skin Syndrome, due to her typical early cutaneous manifestations, no mucosal involvement, and mildly ill appearances.
Keywords: Varicella Bullosa Varicella Zoster Virus