ABSTRACT
Primary infection with varicella zoster virus was assumed to confer lifelong immunity. Nevertheless, cases of varicella reinfection had been reported regardless of immune status. Here the authors described a case of 11-year old girl with nephrotic syndrome, currently on 80 milligrams of prednisolone for one month. She presented with one day of fever, diarrhea and acne-like rash at her forehead, nose and few on the neck. She had a past history of chickenpox. Her vesicles were examined by pediatric dermatologist and Tzanck smear was performed. Multinucleated giant cells were detected and diagnosis of varicella was made. This report infers that positive varicella history alone might not be sufficient to confer immunity, especially in immunocompromised host. Atypical presentation of recurrent varicella in immunocompromised host can be presented.
Subject(s)
Chickenpox/diagnosis , Chickenpox/drug therapy , Nephrotic Syndrome/complications , Nephrotic Syndrome/drug therapy , Acne Vulgaris/diagnosis , Acyclovir/therapeutic use , Antiviral Agents/therapeutic use , Child , Diagnosis, Differential , Drug Therapy, Combination , Female , Glucocorticoids/therapeutic use , Humans , Prednisolone/therapeutic use , RecurrenceABSTRACT
We report a case of nephrotic range proteinuria with 24-hour urine protein level of 335.7 mg/kg/day which developed following dengue hemorrhagic fever. Due to prolonged hypoalbuminemia from renal loss, right pleural effusion persisted and required pleuracentesis. The patient did not have classical nephrotic syndrome. The proteinuria improved without specific treatment. A renal biopsy was not performed due to self-resolution of the proteinuria and azotemia. Heavy proteinuria is not a typical characteristic of dengue virus infection, therefore the pathophysiology of this nephropathy has not been well described to date.
