Varicella complications requiring hospitalization in four hospitals in Santiago, Chile: clinical spectrum and estimation of direct costs

Background: The knowledge complications and their associated cost may help for a better evaluation of varicella immunization benefits. Aim: To determi ne frequency, type, outcome and affected population of varicella complicati ons in children requiring hospitalization and to estimate their direct cost s. Materials and methods: Retrospective analysis of medical records of chil dren admitted to four hospitals in Santiago, Chile due to varicella complic ations between January 1997 and February 1999. Calculation of direct costs of hospitalizations in a sample of 30 patients. Results: One hundred fifty four patients were identified, 7.4% were younger than 5 years old, only one was immunocompromised. Complications identified were skin and soft tissue infections in 63%, invasive infections in 25.3%, neurological in 7.1% and m iscellaneous in 4.5%. Staphylococcus aureus and Group A beta -haemolytic St reptococcus (GABS) were predominantly isolated. S. aureus was the main agen t identified in superficial infections and GABS in invasive infections (ste rile sites). Two patients died due to invasive infections (streptococcal to xic shock and S. aureus septicaemia) and 11 required surgical procedures. T he average cost per hospitalization was US$ 600 in public hospitals and US$ 1,800 in the private hospital. Conclusions: Varicella complications requir ing hospitalization are due mainly to bacterial infections and they affect immunocompetent toddlers. These complications can be severe and even fatal.