CHICKENPOX

Chickenpox or varicella is a primary infection with the varicella-zoster
virus. It is a common, very contagious infection in children. After a mild
prodrome with sometimes fever and malaise the exanthema appears
suddenly. Red macules, papules and shortly thereafter vesicles, pustules
and crusts develop on the trunk, scalp and mucous membranes, less so
on extremities and face. New crops of lesions appear over the next few
days and lesions in all stages of development are seen at the same time.
Itch is the main complaint. Scratching is the main cause of bacterial
superinfection and may cause scarring. Crusts fall off in 1-3 weeks.
Signs, symptoms and complications become more severe with age. In
adults, fever and constitutional symptoms practically always precede the
exanthem. Possible complications include nephritis, myositis, otitis and
meningo-encephalitis.
In immunocompromised persons chickenpox becomes a life-threatening
disease.
Management of chickenpox
- Calamine lotion or phenol-zinc lotion
as necessary for itch and drying in.
- Antihistamines for extreme itch.
Give rest. Isolate patient if possible.
- Use betadine scrub and chlorhexidine
1% mouthwash if necessary.
- In severe superinfection a systemic
antibiotic e.g. cloxacillin or erythromycin.
- Immunocompromised patients:
if available acyclovir 200-800 mg
5 times daily for 5-10 days.