varicella

Question 1

varicella is also known as ____

Answer 1

chicken pox

Question 2

how is varicella transferred?

Answer 2

direct and airborne transmission

Question 3

what is the causative organism of varicella?

Answer 3

herpesvirus varicellae, DNA virus, usually seen during winter and spring

Question 4

how long is the incubation period of varicella?

Answer 4

11-21 days (UP TO THREE WEEKS!)

Question 5

explain the prodrome phase of varicella

Answer 5

fever malaise, anorexia 24 hours prior to rash eruption

Question 6

explain the contagiousness of varicella

Answer 6

the virus is aerosolized from the liquid in blisters, contagious until ALL lesions are scabbed over (approx. 7 days)

Question 7

how does the rash present with varicella?

Answer 7

• generalized, pruritic vesicles on erythematous bases
• “tear-drop” vesicles, filled with yellow/clear fluid BEGIN ON TRUNK, rapidly spread to face and proximal extremities
• vesicles rupture, then small ulcer forms, which quickly forms a small eschar (scab)
• lesions seen at varying stages of healing
• usually do not scar unless excoriated
• rarely, lesions seen in mouth, esophagus, trachea, and intestines

Question 8

after primary varicella infection, varicella virus remains dormant in ____ and is called _____

Answer 8

dorsal root ganglion, herpes zoster

Question 9

if primary varicella infection occurs during first 20 weeks of pregnancy, this is referred to as?

Answer 9

congenital varicella syndrome

Question 10

what are symptoms of congenital varicella?

Answer 10

limb atrophy, cicatrized skin (severe scarring), CNS injury, microcephaly, and eye anomalies
- affected infants usually die in 1st year (if survive, profound neurological abnormalities exist)

Question 11

how would you evaluate or diagnose a patient with varicella?

Answer 11

• mainly a clinical diagnosis
• ELISA titers can be done to confirm, rarely needed
• vaccination given at 12 MONTHS and 5 YEARS

Question 12

how would you treat a patient with varicella?

Answer 12

• self-limited in healthy individuals
• supportive treatment, palliate symptoms (pruritis)
  > oatmeal bathes, creams, benadryl (benadryl cream does not work because molecule too big to absorb into skin!)
• oral acyclovir can decrease duration and number of lesions (controversial, not used often)
• in immunocompromised individuals, IV acyclovir (high dose) x 7-10 days