Chickenpox

Question 1

what infection causes chickenpox?

Answer 1

varicella zoster virus

Question 2

what is shingles?

Answer 2

reactivation of the dormant virus in dorsal root ganglion

Question 3

how is chickenpox spread?

Answer 3

via the respiratory route

Question 4

what is the incubation period of varicella zoster?

Answer 4

10-21 days

Question 5

when is a person with zaricella zoster virus infectious?

Answer 5

4 days before rash —> 5 days after rash first appeared

Question 6

what are the clinical features of varicella zoster virus?

Answer 6

• fever initially
• itchy, rash starting on head/trunk before spreading
• systemic upset is usually mild

Question 7

describe the rash seen in varicella zoster virus?

Answer 7

macular –> papular –> vesicular

Question 8

what is the mainstay of treatment for varicella zoster virus?

Answer 8

supportive

Question 9

what are the NICE guidelines on school exclusion for a child with chickenpox?

Answer 9

most infectious period if 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)

Question 10

what is the management of immunocompromised patients or newborns with peripartum exposure to varicella zoster virus?

Answer 10

• varicella zoster immunoglobulin (VZIG)
• develop chickenpox –> IV acyclovir

Question 11

what is a common complication of chickenpox?

Answer 11

bacterial infection of the lesions

Question 12

what can increase the risk of developing a secondary bacterial infection in chickenpox?

Answer 12

NSAIDs

Question 13

what bacteria is known to cause necrotising fasciitis following secondary bacterial infection in chickenpox?

Answer 13

invasive group A streptococcal infection

Question 14

what are the rare complications of chickenpox?

Answer 14

• pneumonia
• encephalitis
• disseminated haemorrhagic chickenpox
• arthritis, nephritis and pancreatitis