What are the known hemorrhagic complications of chickenpox (varicella)?

Updated: Aug 31, 2020
  • Author: Anthony J Papadopoulos, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

Thrombocytopenia and purpura secondary to VZV infection have been described in more than 100 patients. Hemorrhagic complications are more common in the immunocompromised or immunosuppressed populations, although healthy children and adults have been affected. [12]

Five major clinical syndromes have been described:

  • Febrile purpura

  • Malignant chickenpox with purpura

  • Postinfectious purpura

  • Purpura fulminans

  • Anaphylactoid purpura

These syndromes have variable courses, with febrile purpura being the most benign and having an uncomplicated outcome. In contrast, malignant chickenpox with purpura is a grave clinical condition that has a mortality exceeding 70%.

The etiology of these hemorrhagic chickenpox syndromes is not known, although an autoimmune pathophysiologic mechanism has been implicated.


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