An acute disease with rash, fever, and constitutional symptoms for 3 to 5 days' duration. The rash has maculopapules, vesicles, and scabs in varying stages of evolution; they appear on the trunk and face and rapidly spread centripetally in successive crops over 2 to 4 days.
Occasionally acute disease can cause a meningoencephalitis and cerebellar ataxia.
Pneumonitis is common on CXR, less commonly symptomatic, especially adults; it is more likely to progress in those with hematologic malignancies or pregnancy.
Chickenpox can be deadly in the leukemic/transplant with widespread, destructive disease.
Spread from person to person.
- Normal hosts:
acyclovir 800 mg 5 x a day OR
valacyclovir 1 g tid for 7 to 10 d OR
famciclovir is given at 500 mg tid x 7 to 10 d.
- Heme malignancy/transplants: acyclovir at 10 mg/kg q 8 as well as Varicella zoster immune globulin (VZIG; see package insert);
- Pregnancy: balance the severity of disease vrs the massive paranoia of giving any medication to a pregnant woman; VZIG is also indicated for newborns whose mothers acquire varicella within 5 days before to 48 hours after delivery.
There is a vaccine, it is live attenuated so cannot give to the immunoincompetent and the vaccine will occasionally lead to secondary cases, it does prevent shingles in the adult.
After exposure the non-immune health care worker has to be off work from day 7 to 21.
Immunity is usually forever but there are occasional cases where a normal host had chicken pox more than once (PubMed).
Increases the risk of stroke (PubMed).
Remember, this guide is not written by someone who knows much about peds.
Why is it called chikckenpox? All the answers strike me as BS. They look nothing like chickpeas: "Why the term was used is not clear but it may be due to it being a relatively mild disease. It has been said to be derived from chickpeas, based on resemblance of the vesicles to chickpeas, or to come from the rash resembling chicken pecks. Other suggestions include the designation chicken for a child (i.e., literally 'child pox'), a corruption of itching-pox, or the idea that the disease may have originated in chickens. Samuel Johnson explained the designation as "from its being of no very great danger (Wikipedia)." The term has been around shince 1658.
Last Update: 06/09/18.