Chickenpox natural history: Difference between revisions
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Chickenpox infection is milder in young children, and symptomatic treatment, with a [[sodium bicarbonate]] baths or [[antihistamine]] medication may ease itching.<ref>{{cite journal |author=Somekh E, Dalal I, Shohat T, Ginsberg''''' GM''''', Romano O |title=The burden of uncomplicated cases of chickenpox in Israel |journal=J. Infect. |volume=45 |issue=1 |pages=54-7 |year=2002 |pmid=12217733 |doi=}}</ref> [[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]]. <ref>{{cite web | author=US Centers for Disease Control and Prevention | url=http://www.cdc.gov/vaccines/vpd-vac/varicella/dis-faqs-gen-treatment.htm | title=Varicella Treatment Questions & Answers | work=CDC Guidelines | publisher=CDC | accessdate=2007-08-23}}</ref> | Chickenpox infection is milder in young children, and symptomatic treatment, with a [[sodium bicarbonate]] baths or [[antihistamine]] medication may ease itching.<ref>{{cite journal |author=Somekh E, Dalal I, Shohat T, Ginsberg''''' GM''''', Romano O |title=The burden of uncomplicated cases of chickenpox in Israel |journal=J. Infect. |volume=45 |issue=1 |pages=54-7 |year=2002 |pmid=12217733 |doi=}}</ref> [[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]]. <ref>{{cite web | author=US Centers for Disease Control and Prevention | url=http://www.cdc.gov/vaccines/vpd-vac/varicella/dis-faqs-gen-treatment.htm | title=Varicella Treatment Questions & Answers | work=CDC Guidelines | publisher=CDC | accessdate=2007-08-23}}</ref> | ||
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. | 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]].<ref>{{cite web | title=Definition of Chickenpox | url=http://www.medterms.com/script/main/art.asp?articlekey=2702 | publisher=MedicineNet.com | accessdate=2006-08-18}}</ref>[[Necrotizing fasciitis]]<ref>{{cite web | title=Is Necrotizing Fasciitis a complication of Chickenpox or of Cutaneous Vasculitis?|url=http://www.atmedstu.com/exam%20plus/Is%20Necrotizing%20Fasciitis%20a%20complication%20of%20Chickenpox%20or%20of%20Cutaneous%20Vasculitis.php|publisher=atmedstu.com | accessdate=2008-01-18}}</ref> is also a rare complication. | ||
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]]. | 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]]. | ||
Revision as of 15:46, 27 January 2012
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Natural history
Complications
Prognosis
Chickenpox infection is milder in young children, and symptomatic treatment, with a sodium bicarbonate baths or antihistamine medication may ease itching.[1] 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. [2]
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.[3]Necrotizing fasciitis[4] is also a rare complication.
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.
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. 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%. The etiology of these hemorrhagic chickenpox syndromes is not known.
References
- ↑ 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.
- ↑ US Centers for Disease Control and Prevention. "Varicella Treatment Questions & Answers". CDC Guidelines. CDC. Retrieved 2007-08-23.
- ↑ "Definition of Chickenpox". MedicineNet.com. Retrieved 2006-08-18.
- ↑ "Is Necrotizing Fasciitis a complication of Chickenpox or of Cutaneous Vasculitis?". atmedstu.com. Retrieved 2008-01-18.