-IBIS-1.5.0-
tx
cutaneous system
varicella
diagnoses
definition and etiology
definition:
an acute viral disease characterized by a diffuse eruption that appears in crops and demonstrates the phases of macule, papule, vesicle, then crusting; also known as "chicken pox".
etiology:
The associated microorganism is the varicella-zoster virus, which is also responsible for herpes zoster (reactivation of the virus in a patient who had previously had chickenpox). Chickenpox is extremely contagious (especially in the prodromal and early eruptive stages) and is typically seen in winter through early spring. Spread is by respiratory transmission. Children between the ages of 5-9 years old are the most commonly affected.
signs and symptoms
signs and symptoms:
prodromal: 24-36 hours before lesions appear
malaise, headache
chills and fever
digestive complaints
eruptive: incubation time is typically 10-21 days (average 14-17)
low-grade fever
lassitude
rash: maculopapules, vesicles, and scabs; start on the trunk and face and then spread to the whole body; usual lesion is small with a red base and a diameter of 5-10 mm; successive crops erupt for 2-4 days, and vary in quantity; the rash itches, lasts for 1-2 weeks, and is characterized by concurrent appearance of lesions in all stages of development
lab findings:
isolation of virus in culture
rise in antibody titers
multinucleated giant cells on Tzanck smear
(+) FAMA and ELISA tests
course and prognosis
Complications are rare and recovery is usually uneventful. Mortality in the adult is usually from primary viral pneumonia, and in the infant it is from encephalitis and septic states. In pregnant women, chickenpox may cause birth defects, and neonates acquiring the disease have a 30% mortality rate. Chickenpox is also associated with the development of Reye's syndrome in children who had been given ASA.
Treatment usually includes control of itching, attentive personal hygiene and appropriate antimicrobial therapy for secondary bacterial infections
differential diagnosis
secondary syphilis
impetigo
insect bites
drug reactions
contact dermatitis
infected eczema
erythropoietic porphyria
footnotes