Chicken Pox

Question 1

What is the CO for chicken pox?

Answer 1

• Varicella Zoster Virus

Question 2

Reactivation of the dormant VZV leads to what disease?

Answer 2

• Herpes zoster - Shingles

Question 3

What age group is commonly affected by chicken pox?

Answer 3

• before adolescence (10-19)

Question 4

What are the RF for chickenpox?

Answer 4

• Immunocompromised
• Older age
• Steroid use
• Malignancy

Question 5

What is the incubation period of VZV?

Answer 5

• 10-14 days
• can be up to 21 days

Question 6

What is the presentation of chickenpox like?

Answer 6

• 38-39°C
• Headache, malaise and abdominal pain
• Crops of vesicles
• very itchy
• Stages: papule > vesicle > pustule > crust.

Question 7

What will the presentation for chickenpox be like in immunocompromised pt?

Answer 7

• Skin lesions may continue over several weeks.
• Vesicles can be large and bleed.
• Pneumonia
• Disseminated intravascular coagulation

Question 8

What are the differential diagnosis for chickenpox?

Answer 8

• Generalised herpes zoster or simplex
• Dermatitis herpetiformis
• Impetigo
• Guttate psoriasis
• Other viral skin infections
• Contact dermatitis
• Stevens-Johnson syndrome

Question 9

How would you differentiate shingles from chickenpox?

Answer 9

• shingles - lesion confined to one dermatome

Question 10

What Ix would you order for chickenpox?

Answer 10

clinically diagnosed

For completeion

• craping of a lesion for PCR
• CXR in respiratory sx present
• LP if neurological sx present

Question 11

How would you mx chickenpox in healthy individual?

Answer 11

• adequate fluid intake
• minimising scratching
• avoid contact with pregnant women, neonates and immunocompromised
• analgesia and antipyretics
• antihistamines and emollients
• aciclovir

Question 12

What are the cx of chickenpox?

Answer 12

• secondary skin infection
• necrotising fasciitis
• toxic shock syndrome
• viral pneumonia
• encephalitis
• benign cerebellar ataxia
• myelitis
• vasculitis causing strokes
• osteomyelitis, sepsis, otitis media.

Question 13

What is the fetus at risk of if its mother caught chickenpox in the first 20 weeks of pregnancy?

Answer 13

• congenital varicella syndrome

Question 14

What can congenital varicella syndrome cause?

Answer 14

• intrauterine growth restriction
• microcephaly
• cortical atrophy
• limb hypoplasia
• microphthalmia
• cataracts
• chorioretinitis and cutaneous scarring

Question 15

Infection with chickenpox in > 20 weeks of pregnancy can cause?

Answer 15

• premature delivery
• neonatal chickenpox infection

Question 16

Who is the chickenpox vaccine given to?

Answer 16

• healthcare workers who may come into contact with the disease whilst not immune
• children aged 1-12 years who are close contacts of those people considered to be at high risk of severe chickenpox or shingles infection
• healthy adults and children over 13 years old who are not immune to chickenpox