Chickenpox natural history: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
|||
| Line 12: | Line 12: | ||
===Complications in Immunocompetent=== | ===Complications in Immunocompetent=== | ||
Some of the severe complications associated with chickenpox include:<ref name="pmid12353193">{{cite journal| author=Gnann JW| title=Varicella-zoster virus: atypical presentations and unusual complications. | journal=J Infect Dis | year= 2002 | volume= 186 Suppl 1 | issue= | pages= S91-8 | pmid=12353193 | doi=10.1086/342963 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12353193 }} </ref><ref name="pmid10799624">{{cite journal| author=Laupland KB, Davies HD, Low DE, Schwartz B, Green K, McGeer A| title=Invasive group A streptococcal disease in children and association with varicella-zoster virus infection. Ontario Group A Streptococcal Study Group. | journal=Pediatrics | year= 2000 | volume= 105 | issue= 5 | pages= E60 | pmid=10799624 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10799624 }} </ref><ref name="pmid18567772">{{cite journal| author=de Benedictis FM, Osimani P| title=Necrotising fasciitis complicating varicella. | journal=Arch Dis Child | year= 2008 | volume= 93 | issue= 7 | pages= 619 | pmid=18567772 | doi=10.1136/adc.2008.141994 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18567772 }} </ref><ref name="pmid18419417">{{cite journal| author=Marin M, Watson TL, Chaves SS, Civen R, Watson BM, Zhang JX et al.| title=Varicella among adults: data from an active surveillance project, 1995-2005. | journal=J Infect Dis | year= 2008 | volume= 197 Suppl 2 | issue= | pages= S94-S100 | pmid=18419417 | doi=10.1086/522155 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18419417 }} </ref> | |||
*[[Toxic shock syndrome]] | |||
*[[Necrotizing fasciitis]] | |||
*[[Septicemia]] | |||
*[[Osteomyelitis]] | |||
*[[Bacterial pneumonia]] | |||
*[[Cerebellar ataxia]] | |||
*[[Encephalitis]] | |||
*[[Viral pneumonia]] | |||
*[[Hemorrhagic]] conditions. | |||
*[[Septic arthritis]] | |||
===Complications in Immunocompromised=== | ===Complications in Immunocompromised=== | ||
Revision as of 20:49, 20 June 2017
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aravind Reddy Kothagadi M.B.B.S[2]
|
Chickenpox Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Chickenpox natural history On the Web |
|
American Roentgen Ray Society Images of Chickenpox natural history |
|
Risk calculators and risk factors for Chickenpox natural history |
Overview
Primary varicella is a common childhood disease in Western countries, which presents as pruritic macules, papules, vesicles, pustules, and crusts, usually on the back, chest, face, and abdomen. Anyone who has recovered from chickenpox may develop shingles; even children can get shingles. Two of the most common complications associated with chickenpox are, bacterial infections of the skin and soft tissues in children and Pneumonia in adults. Chickenpox is rarely fatal (usually from varicella pneumonia), with pregnant women and those with a suppressed immune systems being more at risk. Pregnant women not known to be immune and who come into contact with chickenpox may need urgent treatment as the virus can cause serious problems for the baby. This is less of an issue after 20 weeks.
Natural History
Complications
The disease is usually mild, although serious complications sometimes occur. Two of the most common complications are bacterial infections of the skin and soft tissues in children and pneumonia in adults.[1][2][3]
Complications in Immunocompetent
Some of the severe complications associated with chickenpox include:[1][4][5][2]
- Toxic shock syndrome
- Necrotizing fasciitis
- Septicemia
- Osteomyelitis
- Bacterial pneumonia
- Cerebellar ataxia
- Encephalitis
- Viral pneumonia
- Hemorrhagic conditions.
- Septic arthritis
Complications in Immunocompromised
- Hemorrhagic complications are more common in the immunocompromised or immunosuppressed populations, although healthy children and adults have been affected.
- Five major clinical syndromes have been described: febrile purpura, malignant chickenpox with purpura, postinfectious purpura, purpura fulminans, and anaphylactoid purpura.
- The etiology of these hemorrhagic chickenpox syndromes is not known.
- These syndromes have variable courses, with febrile purpura being the most benign of the syndromes and having an uncomplicated outcome.
- In contrast, malignant chickenpox with purpura is a grave clinical condition that has a mortality rate of greater than 70%.
Prognosis
- Chickenpox is rarely fatal (usually from varicella pneumonia), with pregnant women and those with a suppressed immune systems being more at risk. Pregnant women not known to be immune and who come into contact with chickenpox may need urgent treatment as the virus can cause serious problems for the baby. This is less of an issue after 20 weeks.
- Later in life, viruses remaining dormant in the nerves can reactivate causing localised eruptions of shingles. This occurs particularly in people with compromised immune systems, such as the elderly, and perhaps even those suffering sunburn. Unlike chickenpox which normally fully settles, shingles may result in persisting post-herpetic neuralgia pain.
- Chickenpox infection is milder in young children, and symptomatic treatment, with a sodium bicarbonate baths or antihistamine medication may ease itching.[6] Paracetamol (acetaminophen) is widely used to reduce fever. Aspirin, or products containing aspirin, must not be given to children with chickenpox (or any fever-causing illness), as this risks causing the serious and potentially fatal Reye's Syndrome.
- In adults, the disease can be more severe, though the incidence is much less common. Infection in adults is associated with greater morbidity and mortality due to pneumonia, hepatitis and encephalitis. In particular, up to 10% of pregnant women with chickenpox develop pneumonia, the severity of which increases with onset later in gestation. In England and Wales, 75% of deaths due to chickenpox are in adults. Inflammation of the brain, or encephalitis, can occur in immunocompromised individuals, although the risk is higher with herpes zoster.[7]Necrotizing fasciitis
- Secondary bacterial infection of skin lesions, manifesting as impetigo, cellulitis, and erysipelas, is the most common complication in healthy children. Disseminated primary varicella infection, usually seen in the immunocompromised or adult populations, may have high morbidity. Ninety percent of cases of varicella pneumonia occur in the adult population. Rarer complications of disseminated chickenpox also include myocarditis, hepatitis, and glomerulonephritis.
References
- ↑ 1.0 1.1 Gnann JW (2002). "Varicella-zoster virus: atypical presentations and unusual complications". J Infect Dis. 186 Suppl 1: S91–8. doi:10.1086/342963. PMID 12353193.
- ↑ 2.0 2.1 Marin M, Watson TL, Chaves SS, Civen R, Watson BM, Zhang JX; et al. (2008). "Varicella among adults: data from an active surveillance project, 1995-2005". J Infect Dis. 197 Suppl 2: S94–S100. doi:10.1086/522155. PMID 18419417.
- ↑ Straus SE, Ostrove JM, Inchauspé G, Felser JM, Freifeld A, Croen KD; et al. (1988). "NIH conference. Varicella-zoster virus infections. Biology, natural history, treatment, and prevention". Ann Intern Med. 108 (2): 221–37. PMID 2829675.
- ↑ Laupland KB, Davies HD, Low DE, Schwartz B, Green K, McGeer A (2000). "Invasive group A streptococcal disease in children and association with varicella-zoster virus infection. Ontario Group A Streptococcal Study Group". Pediatrics. 105 (5): E60. PMID 10799624.
- ↑ de Benedictis FM, Osimani P (2008). "Necrotising fasciitis complicating varicella". Arch Dis Child. 93 (7): 619. doi:10.1136/adc.2008.141994. PMID 18567772.
- ↑ Somekh E, Dalal I, Shohat T, Ginsberg GM, Romano O (2002). "The burden of uncomplicated cases of chickenpox in Israel". J. Infect. 45 (1): 54–7. PMID 12217733.
- ↑ "Definition of Chickenpox". MedicineNet.com. Retrieved 2006-08-18.