Chickenpox

Question 1

organism

Answer 1

varicella zoster virus

Question 2

how is it spread?

Answer 2

respiratory

Question 3

when is one infective?

Answer 3

4 days before rash, until 5 days after the rash first appeared*

Question 4

features

Answer 4

fever initially

itchy, rash starting on head/trunk before spreading.

Initially macular then papular then vesicular

systemic upset is usually mild

Question 5

management and what can immunocompromised patients be offered

Answer 5

keep cool, trim nails

calamine lotion

school exclusion:
NICE Clinical Knowledge Summaries state the following: Advise that the most infectious period is 1–2 days before the rash appears, but infectivity continues until all the lesions are dry and have crusted over (usually about 5 days after the onset of the rash).

immunocompromised patients and newborns with peripartum exposure should receive varicella zoster immunoglobulin (VZIG). If chickenpox develops then IV aciclovir should be considered

Question 6

common complication

Answer 6

secondary infection

streptococcal infections result in necrotising fascitis

Question 7

rare complications

Answer 7

pneumonia
encephalitis (cerebellar involvement may be seen)
disseminated haemorrhagic chickenpox
arthritis, nephritis and pancreatitis may very rarely be seen