Chickenpox
Alternative names:
varicella
Treatment:
General measures to relieve itching associated with skin lesions include cool water soaks or compresses, and bathing with one cup of baking soda added to a bathtub of lukewarm water. Topical preparations such as nonprescription calamine lotion, antihistamines, or other lotions containing camphor, menthol or phenol may be helpful. Fingernails should be trimmed to prevent scratching, which may lead to a secondary infection. Infant's hands may be covered with a soft cotton or flannel mitten to prevent scratching (the hand should never be restrained).
DO NOT USE ASPIRIN! To reduce fever, use acetaminophen instead of aspirin. Aspirin use during a viral illness, particularly chickenpox, has been associated with a risk of developing Reye's syndrome. A sedative given at night may be prescribed for sleep.
The prescription drug acyclovir has been approved by the FDA for use in treating the symptoms of chicken pox in people over 2 years old. Although acyclovir usually is reserved for teenagers, because the disease is more severe in that age group. The drug should help reduce the severity of chickenpox symptoms, especially in older children and teenagers if taken within 24 hours of the rash's first appearance. It may also be prescribed in severe cases or in people who are immunosuppressed. An alternative antiviral agent is vidarabine.
Children should be kept home from school or day-care until all of the blisters have broken and scabbed over, and they feel well enough to participate in normal activities.
Expectations (prognosis):
The outcome is expected to be excellent in an uncomplicated case. Chickenpox encephalitis, a rare complication of chickenpox, generally has a poor outcome.
Complications: - Women who acquire chickenpox early in pregnancy are at risk for congenital malformations in the fetus (rare).
- Newborns are at risk for severe infection if their mothers are not immune. (They are considered one of the high risk group who should receive VZIG.)
- Secondary infection of blisters (vesicles) with staphylococcus or streptococcus bacteria may occur.
- Encephalitis occurs in less than 1 out of 1,000 cases and tends to occur late in the disease or one to two weeks after the skin lesions have healed.
- Reye's syndrome, pneumonia, myocarditis, and transient arthritis have also been reported as complications of chickenpox.
- Cerebellar ataxia may appear during the convalescent phase or later. Cerebellar ataxia is characterized by a very unsteady walk.
Complications:
- Women who acquire chickenpox early in pregnancy are at risk for congenital malformations in the fetus (rare).
- Newborns are at risk for severe infection if their mothers are not immune. (They are considered one of the high risk group who should receive VZIG.)
- Secondary infection of blisters (vesicles) with staphylococcus or streptococcus bacteria may occur.
- Encephalitis occurs in less than 1 out of 1,000 cases and tends to occur late in the disease or one to two weeks after the skin lesions have healed.
- Reye's syndrome, pneumonia, myocarditis, and transient arthritis have also been reported as complications of chickenpox.
- Cerebellar ataxia may appear during the convalescent phase or later. Cerebellar ataxia is characterized by a very unsteady walk.
Calling your health care provider:
Apply home treatment first. If your child currently has or has recovered from chickenpox in the last two weeks and begins vomiting or becomes restless, agitated or combative call you physician immediately.
Call for an appointment with your health care provider if chickenpox lesions contain pus or appear infected, or if headache, lethargy, or sensitivity to light develop, or if fever persists.
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