{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:10:01Z","timestamp":1756278601156,"version":"3.44.0"},"reference-count":16,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,8,22]]},"abstract":"<jats:p>We report a 16-month-old girl with varicella complicated by cellulitis, invasive Group A <jats:italic>Streptococcus<\/jats:italic> (GAS) infection and deep vein thrombosis. She presented with varicella lesions, fever and a painful firm tumefaction on the right lower leg (RLL). Ultrasound showed a local subcutaneous tissue thickening suggestive of cellulitis and antibiotics were initiated. Further swelling of the RLL motivated a second ultrasound that showed an obstructive thrombus for which she was started on enoxaparin. The blood culture confirmed GAS infection leading to directed antibiotherapy. Additional studies showed positive lupus anticoagulant, decreased protein S and antithrombin. She completed a 2-week course of intravenous antibiotics and anticoagulation therapy with clinical and laboratory markers improvement. However, 3\u2009days later, a recrudescence of symptoms occurred and the ultrasound revealed a local abscess. Further amoxicillin treatment resulted on a complete resolution of symptoms. Doppler ultrasound after 1\u2009month showed markedly increased vein patency.<\/jats:p>","DOI":"10.1136\/bcr-2017-221499","type":"journal-article","created":{"date-parts":[[2017,9,7]],"date-time":"2017-09-07T06:42:56Z","timestamp":1504766576000},"page":"bcr-2017-221499","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Varicella complicated by cellulitis and deep vein thrombosis"],"prefix":"10.1136","volume":"2017","author":[{"given":"Gracinda Nogueira","family":"Oliveira","sequence":"first","affiliation":[{"name":"Hospital Pedi\u00e1trico, Centro Hospitalar e Universit\u00e1rio de Coimbra, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susana","family":"Basso","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Radiologia do Hospital Pedi\u00e1trico, Centro Hospitalar e Universit\u00e1rio de Coimbra, Coimbra, 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