Hemorrhagic chickenpox in a rheumatic child on steroids

Abstract

Chickenpox is normally a highly infectious disease causing a mild illness. However, in patients with malignant disease or who are being treated with corticosteroids a severe hemorrhagic form of the disease may occur which is often fatal. A case of varicella hemorrhagica in a nine year old girl who was being treated with steroids for rheumatic fever is described. Opinions vary as to whether steroids should be increased or decreased, or even discontinued altogether in a child who develops chickenpox while on this treatment. In the case here presented it was felt that since the patient was already on a relatively high dose of steroids, and the chickenpox represented a stressful situation, an increase in the dose of steroids was indicated. It cannot however be concluded that survival of the child could be positively related to the increase in the dose of steroids.