Hematoloji-Onkoloji Hastaları ile İmmünsüprese Hastalarda Su Çiçeği Enfeksiyonu Klinik Sonuçları
Year 2025,
Volume: 15 Issue: 5, 221 - 225, 30.09.2025
Ayşe Akyüz
,
Mustafa Asım Yörük
,
Emine Olcay Yasa
Abstract
Giriş
Suçiçeği (varisella), çocukluk çağının en sık görülen bulaşıcı hastalıklardan biri olmasına rağmen, özellikle immün sistemi baskılanmış hastalarda önemli mortalite ve morbiditeye yol açmaktadır. Bu çalışmada, hematolojik/onkolojik hastalıklar (Grup A) veya diğer nedenlerle (Grup B) immün sistemi baskılanmış hastaların komplikasyonları, hastanede kalış süreleri, antibiyotik ve asiklovir kullanımı ve yoğun bakım ihtiyaçlarının karşılaştırmalı olarak değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntemler
İstanbul Medeniyet Üniversitesi Göztepe Eğitim ve Araştırma Hastanesi Çocuk Enfeksiyon Hastalıkları Kliniği'nde 2008-2016 yılları arasında suçiçeği enfeksiyonu tanısı alan hastaların tıbbi kayıtları retrospektif olarak incelenmiştir. Hematolojik/onkolojik hastalıklar veya diğer nedenlerle immün sistemi baskılanmış hastalar çalışmaya dahil edilmiştir.
Bulgular
Çalışmaya toplam 68 hasta dahil edilmiştir. Hastaneye yatışlar ilkbahar ve yaz aylarının başında en yüksek seviyeye ulaşmıştır. Akut lenfoblastik lösemi, Grup A'da en sık görülen tanı olarak saptanmıştır. Sepsis, Grup A'da daha sık görülürken, cilt enfeksiyonu Grup B'de daha sık görülmüştür. Sepsis ve asiklovir kullanımının Grup A'da anlamlı olarak daha sık olduğu saptanmıştır.
Sonuç
Sonuç olarak, bu çalışma, immünsüpresif hastalarda su çiçeği enfeksiyonunda erken antiviral tedavinin daha az morbidite ve mortalite ile daha iyi prognoz sağlamak için önemini vurgulamaktadır.
References
-
1.Heininger U, Seward JF. Varicella. Lancet. 2006;368(9544):1365-76.
-
2.Kara A. Varisella Zoster Virüs Enfeksiyonlarında Asiklovir Kullanımı. Çocuk Enf Derg. 2007; 1:162-6.
-
3. Grimprel E, Levy C, de La Rocque F, et al; Pediatricians Working Group. Paediatric varicella hospitalisations in France: a nationwide survey. Clin Microbiol Infect. 2007;13(5):546-9.
-
4. Brisson M, Edmunds WJ, Law B, et al. Epidemiology of varicella zoster virus infection in Canada and the United Kingdom. Epidemiol Infect. 2001;127(2):305-14.
-
5. Dinleyici EC, Kurugol Z, Turel O, et al; VARICOMP Study Group. The epidemiology and economic impact of varicella-related hospitalizations in Turkey from 2008 to 2010: a nationwide survey during the pre-vaccine era (VARICOMP study). Eur J Pediatr. 2012;171(5):817-25.
-
6.Peterson CL, Mascola L, Chao SM, et al. Children hospitalized for varicella: a prevaccine review. J diatr. 1996;129(4):529-36.
-
7.Öcal Demir S, Kepenekli Kadayıfçı E, Karaaslan A, et al. The role of acyclovir in the treatment of herpes zoster virus infections in immunocompromised children. J Pediatr Inf. 2015;9:142-6.
-
8. Dilek M , Helvaci M, Aksu N. Evaluation of varicella complications. Abant Med J. 2015;4(4):360-5.
-
9. Celik U, Alhan E, Aksaray N, et al. Varicella-zoster virus infection in children with malignancy. J Pediatr Inf. 2008;3:105-8.
-
10.Streng A, Wiegering V, Liese JG. Varicella in pediatric oncology patients in the post-vaccine era: analysis of routine hospital data from Bavaria (Germany), 2005–2011. Pediatr Hematol Oncol. 2016;33(7-8):468-79.
-
11. Whitley RJ. Varicella-zoster virus. In: Mandell GL, Bennett JE, Dolin R, editors. Mandell, Douglas and Bennett’s principles and practice of infectious diseases. 7th ed. Philadelphia: Elsevier; 2010. p.1963-9.
-
12. Whitley RJ. Varicella-zoster virus. In: Mandell GL, Bennet JE, Dolin R, editors. Principles and practice of infectious diseases. 6th ed. Philadelphia: Elsevier; 2005. p.1780-5.
-
13.Cohen JI, Brunell PA, Straus SE, Krause PR. Recent advances in varicella-zoster virus infection. Ann Intern Med. 1999;130(11):922-32.
-
14. Liese JG, Grote V, Rosenfeld E, Fischer R, Belohradsky BH, von Kries R; ESPED Varicella Study Group. The burden of varicella complications before the introduction of routine varicella vaccination in Germany. Pediatr Infect Dis J. 2008;27(2):119-24.
-
15.Feldman S, Hughes WT, Daniel CB. Varicella in children with cancer: seventy-seven cases. Pediatrics. 1975;56(3):388-95.
-
16. Han CS, Miller W, Hake R, et al. Varicella zoster infection after bone marrow transplantation: incidence, risk factors, and complications. Bone Marrow Transplant. 1994;13:277-83.
-
17. Arvin AM. Antiviral therapy for varicella and herpes zoster. Semin Pediatr Infect Dis. 2002;13(1):12-21.
-
18. Düzgöl M, Özek G, Bayram N, et al. Varicella-zoster virus infections in pediatric malignancy patients: a seven-year analysis. Turk J Haematol. 2016;33(4):346-8.
-
19.Mustafa S. Steroid-induced secondary immune deficiency. Ann Allergy Asthma Immunol. 2023;130(6):713-7.
-
20. Mikaeloff Y, Kezouh A, Suissa S. Nonsteroidal anti-inflammatory drug use and the risk of severe skin and soft tissue complications in patients with varicella or zoster disease. Br J Clin Pharmacol. 2008;65(2):203-9.
-
21.Theodoridou M, Laina I, Hadjichristodoulou C, Syriopoulou V. Varicella-related complications and hospitalisations in a tertiary pediatric medical center before vaccine introduction. Eur J Pediatr. 2006;165(4):273-4.
-
22.Umaretiya PJ, Swanson JB, Kwon HJ, Grose C, Lohse CM, Juhn YJ. Asthma and risk of breakthrough varicella infection in children. Allergy Asthma Proc. 2016;37(3):207-15.
-
23. Lantner R, Rockoff JB, DeMasi J, Boran-Ragotzy R, Middleton E Jr. Fatal varicella in a corticosteroid-dependent asthmatic receiving troleandomycin. Allergy Proc. 1990;11(2):83-7.
-
24.Aljebab F, Choonara I, Conroy S. Long-course oral corticosteroid toxicity in children. Arch Dis Child. 2016;101(9):e2.
-
25. Dowell SF, Bresee JS. Severe varicella associated with steroid use. Pediatrics. 1993;92(2):223-8.
-
26. Hill G, Chauvenet AR, Lovato J, McLean TW. Recent steroid therapy increases severity of varicella infections in children with acute lymphoblastic leukemia. Pediatrics. 2005;116(4):e525-9.
-
27. Wiegering V, Schick J, Beer M, et al. Varicella-zoster virus infections in immunocompromised patients: a single-centre 6-year analysis. BMC Pediatr. 2011;11:31.
-
28. Leuvenink R, Aeschlimann F, Baer W, et al. Clinical course and therapeutic approach to varicella zoster virus infection in children with rheumatic autoimmune diseases under immunosuppression. Pediatr Rheumatol Online J. 2016;14:34.
Comparative Clinical Outcomes of Varicella Infection in Immunosuppressed Pediatric Patients: Hematology-Oncology vs. Other Causes
Year 2025,
Volume: 15 Issue: 5, 221 - 225, 30.09.2025
Ayşe Akyüz
,
Mustafa Asım Yörük
,
Emine Olcay Yasa
Abstract
Aim
Varicella infection (chickenpox) is one of the most common infectious diseases in childhood, yet it may lead significant mortality and morbidity, especially among immunosuppressed patients. This study aims to carry out a comparative evaluation of complications, duration of hospitalization, antibiotic and acyclovir use and intensive care need of patients who were immunosuppressed due to hematological/oncological diseases (Group A) or due to other causes (Group B).
Materials and Methods
The medical records of the patients diagnosed with Varicella infection at Istanbul Medeniyet University Göztepe Education and Research Hospital Pediatric Infectious Diseases Clinic between 2008 and 2016 are retrospectively evaluated. Patients who were immunosuppressed due to hematological/oncological diseases or due to other causes were included in the study.
Results
A total of 68 patients unrolled to the study. Hospitalization peaked in spring and early summer. Acute lymphoblastic leukemia was the most common diagnosis in Group A. Sepsis was more frequent in Group A while skin infection was observed more commonly in Group B. The results revealed that sepsis and acyclovir use was significantly more frequent in Group A,
Conclusion
In conclusion, this study emphasizes the importance of early antiviral therapy for providing favorable prognosis with less morbidity and mortality in varicella infection in immunosuppressed patients.
Ethical Statement
Approval was granted by the Ethics Committee of Istanbul Medeniyet University Göztepe Education and Research Hospital
Supporting Institution
Istanbul Medeniyet University
References
-
1.Heininger U, Seward JF. Varicella. Lancet. 2006;368(9544):1365-76.
-
2.Kara A. Varisella Zoster Virüs Enfeksiyonlarında Asiklovir Kullanımı. Çocuk Enf Derg. 2007; 1:162-6.
-
3. Grimprel E, Levy C, de La Rocque F, et al; Pediatricians Working Group. Paediatric varicella hospitalisations in France: a nationwide survey. Clin Microbiol Infect. 2007;13(5):546-9.
-
4. Brisson M, Edmunds WJ, Law B, et al. Epidemiology of varicella zoster virus infection in Canada and the United Kingdom. Epidemiol Infect. 2001;127(2):305-14.
-
5. Dinleyici EC, Kurugol Z, Turel O, et al; VARICOMP Study Group. The epidemiology and economic impact of varicella-related hospitalizations in Turkey from 2008 to 2010: a nationwide survey during the pre-vaccine era (VARICOMP study). Eur J Pediatr. 2012;171(5):817-25.
-
6.Peterson CL, Mascola L, Chao SM, et al. Children hospitalized for varicella: a prevaccine review. J diatr. 1996;129(4):529-36.
-
7.Öcal Demir S, Kepenekli Kadayıfçı E, Karaaslan A, et al. The role of acyclovir in the treatment of herpes zoster virus infections in immunocompromised children. J Pediatr Inf. 2015;9:142-6.
-
8. Dilek M , Helvaci M, Aksu N. Evaluation of varicella complications. Abant Med J. 2015;4(4):360-5.
-
9. Celik U, Alhan E, Aksaray N, et al. Varicella-zoster virus infection in children with malignancy. J Pediatr Inf. 2008;3:105-8.
-
10.Streng A, Wiegering V, Liese JG. Varicella in pediatric oncology patients in the post-vaccine era: analysis of routine hospital data from Bavaria (Germany), 2005–2011. Pediatr Hematol Oncol. 2016;33(7-8):468-79.
-
11. Whitley RJ. Varicella-zoster virus. In: Mandell GL, Bennett JE, Dolin R, editors. Mandell, Douglas and Bennett’s principles and practice of infectious diseases. 7th ed. Philadelphia: Elsevier; 2010. p.1963-9.
-
12. Whitley RJ. Varicella-zoster virus. In: Mandell GL, Bennet JE, Dolin R, editors. Principles and practice of infectious diseases. 6th ed. Philadelphia: Elsevier; 2005. p.1780-5.
-
13.Cohen JI, Brunell PA, Straus SE, Krause PR. Recent advances in varicella-zoster virus infection. Ann Intern Med. 1999;130(11):922-32.
-
14. Liese JG, Grote V, Rosenfeld E, Fischer R, Belohradsky BH, von Kries R; ESPED Varicella Study Group. The burden of varicella complications before the introduction of routine varicella vaccination in Germany. Pediatr Infect Dis J. 2008;27(2):119-24.
-
15.Feldman S, Hughes WT, Daniel CB. Varicella in children with cancer: seventy-seven cases. Pediatrics. 1975;56(3):388-95.
-
16. Han CS, Miller W, Hake R, et al. Varicella zoster infection after bone marrow transplantation: incidence, risk factors, and complications. Bone Marrow Transplant. 1994;13:277-83.
-
17. Arvin AM. Antiviral therapy for varicella and herpes zoster. Semin Pediatr Infect Dis. 2002;13(1):12-21.
-
18. Düzgöl M, Özek G, Bayram N, et al. Varicella-zoster virus infections in pediatric malignancy patients: a seven-year analysis. Turk J Haematol. 2016;33(4):346-8.
-
19.Mustafa S. Steroid-induced secondary immune deficiency. Ann Allergy Asthma Immunol. 2023;130(6):713-7.
-
20. Mikaeloff Y, Kezouh A, Suissa S. Nonsteroidal anti-inflammatory drug use and the risk of severe skin and soft tissue complications in patients with varicella or zoster disease. Br J Clin Pharmacol. 2008;65(2):203-9.
-
21.Theodoridou M, Laina I, Hadjichristodoulou C, Syriopoulou V. Varicella-related complications and hospitalisations in a tertiary pediatric medical center before vaccine introduction. Eur J Pediatr. 2006;165(4):273-4.
-
22.Umaretiya PJ, Swanson JB, Kwon HJ, Grose C, Lohse CM, Juhn YJ. Asthma and risk of breakthrough varicella infection in children. Allergy Asthma Proc. 2016;37(3):207-15.
-
23. Lantner R, Rockoff JB, DeMasi J, Boran-Ragotzy R, Middleton E Jr. Fatal varicella in a corticosteroid-dependent asthmatic receiving troleandomycin. Allergy Proc. 1990;11(2):83-7.
-
24.Aljebab F, Choonara I, Conroy S. Long-course oral corticosteroid toxicity in children. Arch Dis Child. 2016;101(9):e2.
-
25. Dowell SF, Bresee JS. Severe varicella associated with steroid use. Pediatrics. 1993;92(2):223-8.
-
26. Hill G, Chauvenet AR, Lovato J, McLean TW. Recent steroid therapy increases severity of varicella infections in children with acute lymphoblastic leukemia. Pediatrics. 2005;116(4):e525-9.
-
27. Wiegering V, Schick J, Beer M, et al. Varicella-zoster virus infections in immunocompromised patients: a single-centre 6-year analysis. BMC Pediatr. 2011;11:31.
-
28. Leuvenink R, Aeschlimann F, Baer W, et al. Clinical course and therapeutic approach to varicella zoster virus infection in children with rheumatic autoimmune diseases under immunosuppression. Pediatr Rheumatol Online J. 2016;14:34.