Varicella Zoster
Overview
A highly contagious disease caused by herpes virus 3.
Symptoms
* Fever * Malaise * Vesicular eruptions * Crop lesions * Anorexia * Pruritic * Headache * Rash
Causes
Immunosuppression increases the risk of both typical shingles and atypical presentations, such as myelitis, encephalitis, disseminated disease, and visceral involvement.
Treatment
Chickenpox calls for droplet and contact isolation until all vesicles and most of the scabs are dry (no new lesions; usually 1 week after the onset of the rash). Children with only a few remaining scabs are no longer contagious and can return to school. Congenital chickenpox requires no isolation. In most cases, treatment consists of local or systemic antipruritics: lukewarm oatmeal baths, calamine lotion, or diphenhydramine (or another antihistamine). Antibiotics are unnecessary unless bacterial infection develops. Salicylates are contraindicated because of their link with Reye's syndrome. Susceptible patients may need special treatment. When given up to 72 hours after exposure to varicella, varicella-zoster immunoglobulin may provide passive immunity. Acyclovir and famciclovir, antiviral agents, may slow vesicle formation, speed skin healing, and control the systemic spread of infection.