A healthy 10 year girl developed large expanding ecchymoses on her legs while she was recovering from varicella. She also bled into healing varicella crusts. Although she appeared well, she developed a high fever and laboratory signs of disseminated intravascular coagulation. A skin culture obtained from the crusted papules in the large ecchymoses grew Group A beta-hemolytic streptococcus. She was treated with parenteral antibiotics and fluid resuscitation, and fortunately recovered without complications. The day after her admission to the hospital a new systolic murmur was noted, and a subsequent echocardiogram showed a large clot in the ascending aorta. This also resolved uneventfully.
