Background: Varicella has been known to be a harmless childhood disease. However, it has been reported that severe complications have taken place following Varicella infection, in both immunocompetent, as well as immunocompromised, individuals. Cutaneous complications of Varicella may manifest as preseptal cellulitis, albeit rarely.
Report: We present a case of a 4-year-old boy who presented with symptoms and signs of preseptal cellulitis following Varicella infection. He was referred to the otorhinolaryngology team for a nasoendoscopy to rule out sinusitis, in view of the fear that a child presenting with a swollen red eye may be a case of true orbital cellulitis. He was treated successfully with intravenous antibiotics and surgical drainage of the preseptal collection.
Conclusion: It is imperative for clinicians to be aware that a simple Varicella infection may lead to cutaneous complications in the pediatric age group, especially in children who are 4 years and younger. They may develop preseptal cellulitis, whose presentation might mimic that of orbital cellulitis. Empirical treatment with antibiotics would be advantageous for the patient. A nasoendoscopic examination may also be warranted in these cases to rule out sinusitis as a cause of orbital cellulitis.
A group of 18 male Caucasian workers from the United Kingdom and a further group of 18 male mixed race (mainly Malay) workers from Malaysia employed in the formulation of paraquat-based herbicides were examined for evidence of chronic ill health after long-term exposure to paraquat. Clinical records were examined, medical and occupational histories were obtained and a clinical examination, particularly of the skin, was undertaken. Skin rashes, nail damage and epistaxes were encountered by most workers as a result of direct contact of skin and mucous membranes with paraquat. These conditions subsided rapidly and no worker reported any sequelae. There was no clinical evidence of long-term effects on skin, mucous membranes or general health following exposure to paraquat over several years in these workers.