Varicella Complicated with Immune Thrombocytopenia: A Case Report

Background: Chickenpox is a common infectious disease, usually benign and self-limited. However, it can be associated with complications, requiring hospitalization. This is a case of a previously healthy 4-year-old boy with severe immune thrombocytopenia secondary to chickenpox.

Case Report: A previously healthy 4-year-old boy was admitted to the Pediatric Emergency Department 6 days after being diagnosed with chickenpox, due to bruises on the forearms and lumbosacral region associated with petechiae on the lower limbs and thoracic region. When diagnosed with chickenpox, the child was medicated by his mother with ibuprofen, without improvement. Also emphasize that 10 days prior to the diagnosis, he was medicated with amoxicillin for scarlet fever. Physical examination revealed hemorrhagic vesicular-crusted lesions, petechial and scattered ecchymosis. Laboratory tests results: hemoglobin 10.8 g/dL, WBC count 8,46x103 cells/uL (37,3% neutrophils; 56% lymphocytes) and platelets 2000/uL. Immunological study was normal. Viral markers for hepatitis B, C and HIV were negative. He was treated with intravenous immunoglobulin and the platelet count normalized 5 days after the infusion. He maintained follow-up, during which he presented oscillating platelet counts between 15 and 24,000/uL, with spontaneous normalization after 6 weeks.

Conclusion: Immune thrombocytopenia is a known complication of chickenpox but is very rare in pediatric age. It can cause death due to gastrointestinal or intracranial hemorrhage if left untreated.