Cardiac tamponade after varicella infection

Abstract

Infection with varicella zoster virus is common in childhood and generally associated with few complications. Myopericarditis following varicella infection is rare but may result in severe rhythm disturbances and congestive cardiac failure. The case is presented of a 4-month-old infant presenting with a large pericardial effusion and cardiac tamponade 2 weeks after the onset of a varicella exanthem. Although Streptococcus was noted in the pericardial fluid, it could not be grown on bacterial culture and the subsequent clinical course was in keeping with a viral myopericarditis.

Conclusion Varicella infection in children may be complicated by myopericardial disease ranging from subclinical ECG changes to fulminant cardiac failure and/or cardiac tamponade. The clinical spectrum of this unusual complication is reviewed and the importance of early recognition emphasised.