Varicella zoster causing preseptal cellulitis – uncommon but possible

ABSTRACT

Background: Varicella has been known to be a harmless childhood disease. However, it hasbeen reported that severe complications have taken place following Varicella infection, in bothimmunocompetent, as well as immunocompromised, individuals. Cutaneous complications ofVaricella may manifest as preseptal cellulitis, albeit rarely.Report We present a case of a 4-year-old boy who presented with symptoms and signs ofpreseptal cellulitis following Varicella infection. He was referred to the otorhinolaryngologyteam for a nasoendoscopy to rule out sinusitis, in view of the fear that a child presentingwith a swollen red eye may be a case of true orbital cellulitis. He was treated successfully withintravenous antibiotics and surgical drainage of the preseptal collection.Conclusion: It is imperative for clinicians to be aware that a simple Varicella infection may leadto cutaneous complications in the pediatric age group, especially in children who are 4 yearsand younger. They may develop preseptal cellulitis, whose presentation might mimic that oforbital cellulitis. Empirical treatment with antibiotics would be advantageous for the patient. Anasoendoscopic examination may also be warranted in these cases to rule out sinusitis as a causeof orbital cellulitis.