Infection: Chickenpox Flashcards
What is another term for chickenpox?
Primary varicella zoster infection
What type of virus is chickenpox?
A human herpes virus
Describe the clinical features
Fever initially
Itchy rash, initially starting on head and trunk, progresses to peripheries
50-500 lesions (but may be just a few lesions)
Start as papules/macules then vesicles, pustules and later crust
- appear as crops of vesicles with surrounding erythema
Lesions may occur on palate
What can itching and scratching result in?
Permanent, depigmentated scar formation or secondary infection
A child with chickenpox whose fever initially settles but then recurs days later if likely due to…
Secondary bacterial infection
How is it spread?
Via respiratory route
Can be caught from someone with shingles
Is it highly infectious?
Yes - during viral shedding: 4 days before rash and 5 days after rash first appeared
How long is the incubation period?
10-21 days
Is systemic upset usually mild or severe?
Mild
What complications can occur?
Secondary bacterial infection:
With staphylococci, group A strep or others
May lead to toxic shock syndrome or necrotising fasciitis
Consider when onset of new fever or persistently high
CNS:
Generalised encephalitis - usually occurring early during illness, better prognosis compared to encephalitis caused by HSV
VZV associated cerebellitis - ataxia with cerebellar signs
Aseptic meningitis
Immunocompromised: Haemorrhagic lesions Pneumonitis Progressive disseminated infection DIC
Arthritis, pancreatitis, nephritis in rare cases
How is it managed?
Keep cool Trim nails Calamine lotion School exclusion Immunocompromised patients and newborns exposed peripartum - varicella zoster immunoglobulin. If they develop chickenpox: IV acyclovir
