Paediatrics OTC - Chicken Pox

Question 1

What are the main features of chicken pox? (7)

Answer 1

Caused by varicella zoster.
Can represent as shingles in adulthood (reactivation).
Transmitted by airborne inhalation/lesions exudate or via lesion infected clothing.
Incubation ranges 15-18 days and infectious 1-2 days before and around 6 days after first crop of vesicles appear.
Prodromal phase: present for up to 3 days of fever, headache and sore throat.
Lesions can develop on the head and neck and spread to the trunk.
Accepted that a person is infectious until all lesions crust over.

Question 2

What are the tx options for chicken pox? (2)

Answer 2

Aciclovir (POM) = adults or immunocompromised.
Shorten duration of illness
ABx (POM)
Supportive tx:
- Fluids
- Analgesics = X NSAIDs
- Antihistamines - sedative (best)
- Frequent cool washes, inclusion of sodium bicarbonate.
- Topical application of calamine lotion or cream.

Question 3

Which tx option should NOT be offered to patients with chicken pox? (1)

Answer 3

NSAIDs

Question 4

What are the complications of Chicken pox? (7)

Answer 4

Secondary infection
Staph aureus
Strep pyogenes
Scarlet fever or TSS
Severe chicken pox
Chicken pox encephalitis
Thrombocytopenia

Question 5

What is the differential diagnosis of chicken pox? (1)

Answer 5

Molluscum Contagiosum

Question 6

What are the main features of Molluscum Contagiosum? (7)

Answer 6

Molluscum Contagiosum:
- Viral skin infection caused by MCV.
- Spots 2-5mm wide and appears together. They’re raised and dome-shaped with a shiny white dimple in middle.
- Self-limiting condition - spontaneous resolution within 18 months.
- Give general advice to avoid spread of infection.
- Lesions = contagious = avoid sharing towels, clothing or bedding.
- Exclusion from school/swimming not necessary.
- If possible, cover lesions with waterproof bandages or clothes prior to swimming.