Chickenpox

Chickenpox is a common, highly infectious illness caused by primary infection with the varicella zoster virus (VZV). Diagnosis is clinical. Treatment is supportive.

It peaks at 6 – 15 years and affects men and women equally.

• Signs and symptoms
  • Fever
  • Rash
    • Occurs in “crops” consisting of a handful of spots
    • Initially macular → papular → vesicular → crusting and patches
    • May be pruritic
    • Women may have painful vulval lesion
    • Starts on the head/trunk before spreading
  • Mild systemic upset
• Investigaions
  • Swabs of fluid from the blister for laboratory confirmation
• Treatment
  • Trim nails and avoid scratching
  • Antihistamines and emollients to reduce the itch
  • Avoid pregnant women, neonates, and immunocompromised individuals
  • Paracetamol for fever and headache – avoid NSAIDs since they increase the risk of GAS infection; avoid aspirin since it increases the risk of Reye syndrome
  • Exclude the child from school for 5 days after the onset of the rash (or until the lesions are dry and crusted over)
  • IV acyclovir for pregnant women or immunocompromised individuals – it reduces disease severity
  • Varicella zoster immunoglobulin (VZIG) for immunocompromised patients or newborns with peripartum exposure.
• Complications
  • Secondary skin infection: cellulitis and necrotizing fasciitis
  • Pneumonitis
  • Encephalitis
  • Disseminated hemorrhagic chickenpox
  • Arhtirits
  • Nephritis
  • Pancreatitis