{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T17:48:11Z","timestamp":1777312091755,"version":"3.51.4"},"reference-count":32,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024]]},"abstract":"<jats:p>\n                    Background: The introduction of the varicella vaccine has led to a significant decrease in pediatric varicella-induced invasive\n                    <jats:italic>Streptococcus pyogenes<\/jats:italic>\n                    (group A streptococcal [GAS]) infections. However, the development of a pleural empyema following a chickenpox infection is a rare complication in pediatric patients.\n                  <\/jats:p>\n                  <jats:p>Case presentation: In this report, we present a 5-year-old male patient who presented to the emergency department with a deteriorating course two days after a chickenpox infection. The patient complained of high-grade documented fever, a congested throat, abdominal pain, shortness of breath, and most importantly, decreased air entry on the right side of the chest, along with the presence of crepitations. Such a deteriorated clinical picture suggested the presence of an infectious cause. The patient\u2019s physical examination and radiological imaging provided evidence for the presence of lower right-sided lobar pneumonia. On the second day of hospitalization, the patient showed worsening respiratory distress, prompting further investigations that confirmed the development of a right-sided pleural empyema through radiological imaging. Pediatric surgery consultation was requested, and 500 cc of pus was drained following the insertion of a chest tube, which was later sent for analysis. The patient\u2019s clinical picture improved significantly following this intervention. Due to the severity of his condition, the patient was transferred to the pediatric intensive care unit (PICU) for close monitoring. After one night in the PICU, during which his condition stabilized and oxygen therapy was gradually weaned off, the patient continued to improve on the general ward. Daily assessments and laboratory tests showed decreasing inflammatory markers and resolution of symptoms. Following three days of admission and confirmation of no underlying immunologic deficiency, the patient was discharged home with appropriate antibiotic therapy and follow-up instructions.<\/jats:p>\n                  <jats:p>Discussion: Similar cases have been sporadically documented in pediatric literature, with notable examples involving older patients. The pathophysiology involves complex immune interactions and virulence factors of GAS, contributing to severe outcomes such as pleural effusion.<\/jats:p>\n                  <jats:p>Conclusion: In this case, the 5-year-old patient experienced a severe progression from chickenpox to pleural empyema but ultimately improved following prompt medical intervention and chest tube drainage. The patient was discharged after a successful recovery, highlighting the efficacy of early recognition and treatment in managing such complications.<\/jats:p>","DOI":"10.5339\/qmj.2024.67","type":"journal-article","created":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T08:30:38Z","timestamp":1731400238000},"source":"Crossref","is-referenced-by-count":0,"title":["Development of Streptococcus pyogenes pneumnonia and pleural empyema post-chickenpox infection in a 5-year-old child: A case report"],"prefix":"10.5339","volume":"2024","author":[{"given":"Majed Abu","family":"Jaish","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Arab Women\u2019s Union Hospital, Nablus, Palestine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mai","family":"Akila","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Arab Women\u2019s Union Hospital, Nablus, Palestine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1353-4058","authenticated-orcid":true,"given":"Yazan","family":"AlHabil","sequence":"additional","affiliation":[{"name":"Department of Human Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine*Correspondence: Yazan AlHabil yazanalhabil@gmail.com"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3277","reference":[{"key":"CIT0001","series-title":"Curr Pediatr Rev","first-page":"70\u20133","article-title":"Group A Streptococcal infections in children","volume":"17","author":"Ahmed\n \nMI","year":"2021;"},{"key":"CIT0002","series-title":"Pediatr Pulmonol","first-page":"2700\u20136","article-title":"Factors associated with complicated pneumonia in children","volume":"56","author":"Masarweh\n \nK","year":"2021;"},{"key":"CIT0003","series-title":"Pediatr Infect Dis J","first-page":"799\u2013802","article-title":"Characteristics of Streptococcus pyogenes versus Streptococcus pneumoniae pleural empyema and pneumonia with pleural effusion in children","volume":"39","author":"Megged\n \nO","year":"2020;"},{"key":"CIT0004","series-title":"Pediatrics","first-page":"E60","article-title":"Invasive group A streptococcal disease in children and association with varicella-zoster virus infection. 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