GROUP-A STREPTOCOCCAL NECROTIZING FASCIITIS FOLLOWING VARICELLA IN CHILDREN - CASE-REPORTS AND REVIEW

We report four cases of necrotizing fasciitis that occurred following varicella in children ranging in age from 2 to 8 years, The only organ ism isolated from each of these patients was Streptococcus pyogenes or group A beta-hemolytic Streptococcus (GABHS), Each child recovered; h owever, three required repeated surgical debridements in addition to t herapy with antibiotics, An interesting finding in these patients was the development of hyponatremia and/or hypocalcemia, M-typing and T-ty ping of the isolates demonstrated that the GABHS strain in two childre n who attended the same school was M5; M1 and M3 strains were identifi ed in the other two children, In addition to the children described in this series, eleven other cases of children with necrotizing fasciiti s following varicella have been reported in the English-language liter ature since 1970, We believe that these cases provide further evidence that varicella is an important risk factor for necrotizing fasciitis that is caused by more-virulent strains of GABHS.