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    Prabhat Ranjan
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    Varicella, also known as chickenpox, is a highly infectious disease caused by primary infection with varicella zoster virus (VZV). It is characterized by an exanthematous vesicular rash that spreads in a centripetal pattern. Transmission occurs via direct contact with skin lesions, through airborne routes, or transplacentally. Complications can include bacterial infections of the skin or other organs, as well as neurological manifestations in rare cases. Treatment focuses on supportive care, with antiviral therapy recommended for severe or complicated cases.

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    Varicella, also known as chickenpox, is a highly infectious disease caused by primary infection with varicella zoster virus (VZV). It is characterized by an exanthematous vesicular rash that spreads in a centripetal pattern. Transmission occurs via direct contact with skin lesions, through airborne routes, or transplacentally. Complications can include bacterial infections of the skin or other organs, as well as neurological manifestations in rare cases. Treatment focuses on supportive care, with antiviral therapy recommended for severe or complicated cases.

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    10 views15 pages

    Varicella

    Uploaded by

    Prabhat Ranjan
    Varicella, also known as chickenpox, is a highly infectious disease caused by primary infection with varicella zoster virus (VZV). It is characterized by an exanthematous vesicular rash that spreads in a centripetal pattern. Transmission occurs via direct contact with skin lesions, through airborne routes, or transplacentally. Complications can include bacterial infections of the skin or other organs, as well as neurological manifestations in rare cases. Treatment focuses on supportive care, with antiviral therapy recommended for severe or complicated cases.

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    of 15

    Varicella

    - Highly infectious ds caused by primary infection of VZV,


    Characterized by an exanthematous vesicular rash with a centripetal
    distribution.
    -
    Epidemiology – global incidence –
    1300-1600 cases/10 lac population.
    - more in temperate climate than tropical climate.
    - more in spring and winter season.
    - 52-70 % infection in < 6 yrs ages, 5-7% in adult.
    Agent- an enveloped DNA virus of the family of Herpes.
    TRANSMISSION –
    - Direct contact with skin lesion.
    -Airborne route.
    - Transplacentally.
    - Infectivity period – 48 hrs prior and upto 3-7 days after rash.
    Etiopathogenesis – Primary seeding in tonsillar lymphoid
    tissue and mucosa of upper RES. TRACT.

    Primary viremia –within 4-6 days of infection.


    Secondary viremia – last 3-7 days ,cutaneous lesion.
    Clinical feature –
    I. Period – 10-21 days.[ median I. P 14-16 DAYS]
    Prodromal phase – headache, sore throat, backache,
    fever moderate , resolve after 3-4 days of rash.

    Rash – within 24 hrs of prodromal phase.


    - Crops of macules – papules – vesicles , clear fluid then
    cloudy. Pustular and crust.
    Rash appears 1st scalp, face or trunk.
    Ulcerative lesion involving the mucosa of the oropharynx
    and vagina. Vesicle observed over conjunctiva, palate, tounge
    and buccal mucous membrane.
    Scab fall off in 10-20 days with Hypo or Hyperpigmentation
    BREAKTHROUGH varicella –
    Is ds that occurs in a person vaccinated > 42 days before rash
    onset.
    NEONATAL varicella – varicella in the period from 5 days
    prior to delivery to 2 days afterward are the high risk for
    severe varicella.
    Rash appear towards the end of the 1st wk to the early of the
    2nd wk of life.
    CONGENITAL VARICELLA SYNDROME
    Occur due to maternal VZV infection during 1st or 2nd trimester
    .the risk 5% in 1st, 10% in 2nd and 25% in 3rd trimester.
    Cicatricial scarring of the limb characterized by zig zag
    scaring of skin in dermatomal pattern with limb hypoplasia.
    Neurological – cortical atrophy, microcephaly, seizure and
    MR.
    Eye - CHORIORETINITIS ,MICROPHTHALMIA,
    cataract and nystagmus.
    Renal – hydroureter and hydronephrosis.
    Digital defect
    Autonomic nervous system – neurogenic bladder ,swallowing
    dysfunction ,aspiration pneumonia.
    COMPLICATION –
    Bacterial - gr A streptococcal , staph.
    Cellulitis ,skin abcess, pneumonia , osteomyelitis, S.
    ARTHRITIS.
    Neurological – cerebellar ataxia , M.encephalitis, G B
    syndrome, ADEM, T.myelitis, acute infantile hemiplegia.
    OTHER – Myo, peri ,endocarditis.
    Hepatitis ,GN, APPENDICITIS, keratoconjuctivitis, DIC,
    Steven- johnson syndrome ,thrombocytopenia.
    Diagnosis –
    - clinical
    - CBC
    - Rapid lab diag – Electron microscopy , immunofluorescence.
    PCR , Tzank smear.
    - virus isolation and culture.
    - - Ig M 1-7 DAYS OF INFECTION.
    - - Ig G 9-19 days of infection.
    Treatment –
    supportive therapy.
    Specific therapy- Acyciovir.
    Indication – chronic cutaneous or pulmonary disorder.
    Received corticosteroid.
    -receiving long term salicylate.
    -immunocompromised patient, HIV, Malignancy.
    - Disseminated varicella infection.
    t\t cont.
    Neonate – iv acyclovir 10 mg/kg TDS 14 -21 days.
    Infants 0-1 yr – oral acyclovir 20mg/kg 7-10 days.
    Children 1-13 yrs – no antiviral but iv in a complicated.
    ADOLESCENT – oral acyclovir 20mg/kg /dose 7-10 days.
    PREVENTION – Active immunization.
    Postexposure Prophylaxis – VZIG 125 U NEWBORN.
    HERPES ZOSTER
    reactivation of latent varicella zoster virus infection.
    - less common in children.
    - characterized by localized unilateral painful vesicular
    eruption
    over 1-3 dermatomal segment, more pruritus and painful.
    Subclinical zoster – dermatomal pain without rash.
    - Generally self limiting .

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