Eight children with post-varicella musculoskeletal complications were treated between 2001 and 2009. The complications that were observed were cellulitis (three children), pyomyositis (three children), osteomyelitis (two children) and gangrene (one child). On average, 8.8 days elapsed between primary varicella infection and complication. The most common presentation was pain. Before we started treating them, all children received antibiotics during interhospital transfers (average: 2.4). Interventions included drainage (eight), fasciatomy (one), arthrotomy (one), bone drilling (one), and amputation (one). Blood cultures were negative in all children. Two children had positive pus cultures for Staphylococcus aureus, one of them had a methicillin-resistant S. aureus infection. One of the four children who developed coagulopathy ended with significant morbidity. Varicella-related methicillin-resistant S. aureus osteomyelitis suggests a widening spectrum of these infections.
aMinistry of Health, Division of Paediatric Orthopaedics, Al-Razi Orthopaedic Hospital
bMinistry of Health, Department of Orthopaedics, Al-Farwania Hospital, Kuwait
Correspondence to Dr Anil K Gupta, MBBS, MS, DNB (Ortho), MAMS, FACS, Ministry of Health, Division of Paediatric Orthopaedics, Al-Razi Orthopaedic Hospital, PO Box 42327, Shuwaikh, 70654, Kuwait Tel: +965 99801860; fax: +965 24821998; e-mail: firstname.lastname@example.org