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Chicken Pox
Chicken pox is a common childhood viral infection. In adults who are not immune, the symptoms are usually much more severe, and pneumonia may develop. Chicken pox is related to the infection we know as shingles, because both are caused by the same virus. This infection will commonly start as an upper respiratory infection with symptoms of runny nose, fever, and sore throat. A cough may be present, but it is usually dry and nonproductive. Any associated shortness of breath could indicate a viral pneumonia, which can be a serious problem. Eventually a rash erupts, first on the face or trunk finally spreading to the limbs. The rash starts as red spots that later turn to blistery bumps (vesicles). The rash will eventually crust over, scab, and only rarely cause scarring. This process may take 7-14 days. After the blisters have scabbed over, the child is generally considered to be noninfectious to others. More commonly, other children become infected before the characteristic rash appears and the diagnosis can be made. Evaluation includes history for possible chicken pox exposure and physical examination. Most physicians make this diagnosis without any pecial tests, but serologic blood tests (varicella antibody titers) can be done in those questionable cases. Treatment is supportive in the majority of cases. Fever control is with acetaminophen, NOT aspirin, because of the association with Reye's syndrome. Treatment includes bedrest, plenty of fluids, and (Calamine) or (Caladryl) lotion to help reduce itching. Antihistamines, such as (Benadryl), can also reduce itching. These medication is available without a prescription. Patients with viral pneumonia may be hospitalized and treated with special anti-viral medications (acyclovir). Some physicians feel oral acyclovir can decrease the severity of the symptoms and shorten the course of the illness. This can often be helpful in the adult patient who has chicken pox.
Chicken pox in pregnancy (particularly early pregnancy) does expose some risk of congenital abnormalities in the fetus. Every attempt should be made so pregnant females are not exposed to a patient with chicken pox.
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