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Archives de pédiatrie
Volume 19, n° 10
pages 1074-1078 (octobre 2012)
Doi : 10.1016/j.arcped.2012.07.006
Received : 1 February 2012 ;  accepted : 9 July 2012
Pneumopathie fulminante au cours de la varicelle chez une fillette de 16 mois immunocompétente
Fulminant pneumonia during varicella in an immunocompetent 16-month-old girl
 

K.-V. Asse a, , H. Rekik a, J.-C. Ropert a, H. Pejoan a, G. Kharsa b
a Service de pédiatrie–néonatologie, centre hospitalier Courbevoie-Neuilly-Puteaux, 36, boulevard du Général-Leclerc, BP 79, 92205 Neuilly-sur-Seine cedex, France 
b Laboratoire d’anatomie et cytologie pathologique, centre hospitalier Courbevoie-Neuilly-Puteaux, 36, boulevard du Général-Leclerc, BP 79, 92205 Neuilly-sur-Seine cedex, France 

Auteur correspondant.
Résumé

La varicelle est une infection virale cosmopolite, très contagieuse, due au virus varicelle-zona (VZV) et caractérisée par de la fièvre et une éruption papulo-vésiculeuse prurigineuse. Le traitement symptomatique a pour but de normaliser la température, de contrôler le prurit et d’éviter la surinfection bactérienne. Les formes graves, les formes compliquées et le décès surviennent chez la femme enceinte, le nouveau-né, l’enfant immunodéprimé et l’adulte non immunisé. Contrairement à l’adulte immunocompétent chez qui une pneumopathie varicelleuse est observée dans 50 % des formes compliquées, cette complication est rare chez l’enfant. Nous rapportons un cas de varicelle compliquée d’une pneumopathie hypoxémiante d’évolution fatale chez un nourrisson de 16 mois sans déficit immunitaire connu. Nous discutons à partir d’une revue de la littérature les principaux aspects diagnostiques, thérapeutiques et évolutifs. La prévention de la varicelle repose sur la vaccination indiquée à partir de l’âge de 12 mois.

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Summary

Varicella is a cosmopolitan communicable disease caused by varicella-zoster virus (VZV) characterized by papulovesicular rash and fever. Management of fever and pruritus and prevention of bacterial infection are the main aspects of treatment. Severe complications and death may occur in pregnancy, in newborns, in adults, and in immunocompromised children. Contrary to immunocompetent adults in whom pneumonia occurs in 50% of cases during varicella, this complication in children is rare. We report a fatal case of pneumonia with severe hypoxemia during varicella in an immunocompetent 16-month-old child. Based on a literature review, we discuss the main aspects of diagnosis, treatment, and prognosis of varicella. Active immunization of children after 12 months of age is the primary prevention of varicella.

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