Varicella: Difference between revisions
Neil.m.young (talk | contribs) (edits to treatment with ref) |
|||
| Line 19: | Line 19: | ||
==Treatment== | ==Treatment== | ||
*Tylenol, antihistamine, oatmeal baths | *Tylenol, antihistamine, oatmeal baths | ||
*No Aspirin (may predispose to Reye | **No Aspirin (may predispose to Reye's Syndrome) | ||
*Routine use of antiretrovirals for uncomplicated cases in immunocompetent children is not recommended | *Routine use of antiretrovirals for uncomplicated cases in immunocompetent children is not recommended in Tintinallli 7th ed | ||
*Immunocompromised: IV | *However, evidence shows decreased days of fever and number of lesions<ref>Klassen TP, et al. Acyclovir for treating varicella in otherwise healthy children and adolescents. Cochrane Database Syst Rev. 2005; (4):CD002980.</ref> | ||
**Consider Acyclovir20 mg/kg (up to 800 mg) PO q6hrs x 5 days for children >12 y/o | |||
*Immunocompromised<ref>Drugs for non-HIV viral infections. Treat Guidel Med Lett. 2007; 5(59):59-70.</ref>: | |||
**≤12 yrs - Acyclovir 20 mg/kg IV q8hrs x 7-10 days | |||
**>12 yrs - Acyclovir 10 mg/kg IV q8hrs x 7 days | |||
==Complications== | ==Complications== | ||
Revision as of 16:11, 22 April 2015
Background
- Caused by varicella zoster virus causing varicella (chicken pox) and later zoster (Shingles)
- Contagious until last lesion crusts over
Diagnosis
- Pruritic generalized vesicular exanthem w/ mild systemic manifestations
- Usually affects children <10y
- Rash
- Starts on trunk or scalp as pruritic, red macules, spreads to extremities
- W/in 24hr rash becomes vesicular (on erythematous base)
- Palms/soles spared
- Lesions in various stages of development
Differential Diagnosis
Pediatric Rash
- Atopic dermatitis
- Bed bugs
- Contact dermatitis
- Drug rash
- Erythema infectiosum (Fifth disease)
- Hand-foot-and-mouth disease
- Henoch-schonlein purpura (HSP)
- Herpangina
- Herpes simplex virus (HSV)
- Infectious mononucleosis
- Meningitis
- Measles
- Molluscum contagiosum
- Roseola infantum
- Rubella (German measles)
- Scabies
- Scarlet fever
- Smallpox
- Varicella (Chickenpox)
Treatment
- Tylenol, antihistamine, oatmeal baths
- No Aspirin (may predispose to Reye's Syndrome)
- Routine use of antiretrovirals for uncomplicated cases in immunocompetent children is not recommended in Tintinallli 7th ed
- However, evidence shows decreased days of fever and number of lesions[1]
- Consider Acyclovir20 mg/kg (up to 800 mg) PO q6hrs x 5 days for children >12 y/o
- Immunocompromised[2]:
- ≤12 yrs - Acyclovir 20 mg/kg IV q8hrs x 7-10 days
- >12 yrs - Acyclovir 10 mg/kg IV q8hrs x 7 days
Complications
- Can include encephalitis, pneumonia, hepatitis, strep/staph superinfection of ruptured vesicles
- Perinatal infection in neonates may develop serious illness