Chickenpox is caused by the varicella zoster virus and results in a primary infection called varicella (chickenpox) and recurrent infection called herpes zoster (shingles). The incubation period is 10-21 days. The virus spreads one to two days before the rash appears until all lesions have crusted, which is 5-7 days. The clinical presentation involves an invasion stage with symptoms, followed by a rash that progresses from macular to papular to vesicular to pustular lesions. Complications can involve the skin, respiratory system, kidneys, or be systemic. Diagnosis is usually based on the characteristic rash, but tests like PCR or antibody titers can also

1. Chickenpox (VARICELLA)
Dr. BOUNIKA ESVANTH RAO,
Dr. JERUBA JAYAKUMAR,
Dr. NEELAVENI MARIMUTHU SAMY,
Dr. PRIYADHARSHINI JOTHI MURUGAN.

2. ETIOLOGIC AGENT
 Caused by varicella zoster virus related to
Herpes simplex virus
Cytomagalo virus
Epstein bar virus (EBV)
 Primary infection results in Varicella.
 Recurrent infection results in herpes zoster
(shingles).
 Source :
&

3. INCUBATION PERIOD
 10- 21 days.
SPREAD OF DISEASE
&
INFECTIOUS PERIOD
 One two days before the appearance of the
rash and lasts till all the lesions have
crusted (5-7 days).

4. CLINICAL PICTURE
 Stage of invasion / prodromal
stage.
 Stage of eruption.
 Convalescence

5. STAGE OF INVATION (2-3 days)
 Symptoms
 Before the
appearance of the
skin rash enantham
develops

6. STAGES OF ERUPTION
 Progress of lesion
Macular Papular Vesicular Pustular

7. CONVALECENCE
•Rashes lasts for 3-4 days.
•Formation of scabs.
•Superficial scars.
 Complete clearance of skin may take
few days.

8. VARITIES OF CHECKEN POX
 Varicella bulla: characterized by
formation of bullous eruptions.
 Varicella ganrenosa: It is seen in ill-
nourished children and there are dark
crusts are formed in the eruptions which
on separation leave behind ulcers.
 Varicella haemorrhagica: Uncommon
virulent form of varecella . Hemorrhages
occur into the vesicles and bleeding may
take place from the mucous membrane.

9. COMPLICATIONS
 RESPIRATORY:
 Laryngitis, Bronchitis, Bronchopneumonia.
 SKIN:
 Erysipelas, Cellulitis, Impetigo.
 RENAL:
 Nephritis .
 SYSTEMIC:
 Arthritis, Myocarditis, Purpura,
Encephalomylitis.

10. SEVERE IN

11. DIAGNOSIS
 Classical appearance of rash.
 Aspiration of vesicular fluid.
 PCR tissue culture.
 Serological examination for rising titers of
antibodies is only useful in primary
infection.
 Staining of scrapings in with fluorescein
labeled monoclonal antibody.

12. TREATMENT
Use of antivirals
Indications:
For those patients for whom VZIG
is not indicated
Dose:
Oral acyclovir
40mg/kg/day in 4 divided doses
given from days 7 to 14 after
exposure
(Kumagai et al, 1999)

13. PROPHYLAXIS
Dosage and Timing of VZIG
(to be given within 10 days of exposure).
0 – 5 Years 250mg by
6 – 10 Years 500mg slow
11 – 14 Years 750mg intramuscular
15 years and older 1000mg injection
PASSIVE IMMUNISATION
LIVE ATTENUATED VARICELLA VACCINE (VARIVAX)
In a dose of 0.5 ml is administered in all children
above the age of 21 months for immunization.
A booster dose after 6 years of vaccination is given in
some children.

14. PROGNOSIS
A case of chicken pox has a self limiting
course and in an uncomplicated case
prognosis is good.

15. ANY QUESTIONS?