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Varicella is usually self-limiting but occasionally severe infectious disease (with 2 to 6% of cases resulting in complications). The aim was to report a case with hemorrhagic-necrotic rash, discrete cerebellar ataxia and immune suppression. A two-year-and-seven-month-old boy with fever, tonsillitis and rose-colored-spots rash was treated with Amoxiclav and antihistamines followed by improvement. Eight days after treatment, fever, vesiculous rash (consequently hemorrhagicnecrotic) and enlarged lymph nodes appeared. On admission, the child was in severe condition, with generalized polymorph rash (vesicles with bloody content on necrotic surface, few crusts), generalized enlarged and painful lymph nodes, increased breath and heart rates, hepatosplenomegaly, depressed patellar and Achilles reflexes, positive Babinski sign; without signs of meningeal irritation. Ataxia had observed and Romberg was positive. Laboratory investigations revealed anemia, thrombocytopenia and normal humoral immunity. Lymphopenia (12.28%), decreased total Т-lymphocytes, normal CD4+/ CD8+ T-lymphocytes ratio at normal CD4+ and decreased CD8+ Т cells, increased В-lymphocytes were found by flow-cytometry. Serological investigations (ELISA) revealed significant titers of specific IgM antibodies against three different herpesviruses (HSV-1, HSV-2 and Varicella zoster virus). Complex etiologic and supportive treatment was administered. The child had improved after sixth day and was discharged on eleventh day . Hemorrhagic-necrotic form of varicella is rare. It occurs mainly in immunocompromised patients, but immunocompetent individuals also could be affected. This requires the use of broad diagnostic panel for precise etiological diagnosis, which will facilitate the proper treatment and favorable outcome.

Complications of Varicella – Report of Case with Hemorrhagic-Necrotic Rash and Cerebellar Ataxia