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Chickenpox (Varicella Zoster)

Andrew J. Richardson, MD Reviewed 06/2020
 


BASICS

DESCRIPTION

  • Highly contagious, generalized exanthem characterized by crops of pruritic vesicles on the skin and mucous membranes following exposure to varicella-zoster virus (VZV).

  • VZV is spread ...

DIAGNOSIS

HISTORY

  • Prodromal symptoms: fever, malaise, anorexia, mild headache

  • Malaise, muscle aches, arthralgias, and headache are more common in adults.

  • Subclinical in ~4% of cases

  • Characteristic rash

PHYSICAL EXAM

TREATMENT

Generally outpatient, except for complicated cases 

GENERAL MEASURES

  • Supportive/symptomatic treatment

  • Antihistamines and/or oatmeal baths for itch

  • Acetaminophen and/or ibuprofen for pain and fev...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Not needed in mild cases. Intensive supportive care may be required in the setting of complications.

  • Activity as tolerated. Children may return t...

REFERENCES

1
National Notifiable Infectious Diseases and Conditions: United States. https://www.cdc.gov/chickenpox/health-departments/conducting-surveillance.html. Accessed September 20, 2019.
2
Marin M,...

ADDITIONAL READING

  • Dooling KL, Guo A, Patel M, et al. Recommendations of the Advisory Committee on Immunization Practices for use of herpes zoster vaccines. MMWR Morb Mortal Wkly Rep.  2018;67(3)...

CODES

ICD10

  • B01.9 Varicella without complication

  • B02.9 Zoster without complications

  • P35.8 Other congenital viral diseases

  • Z20.820 Contact with and (suspected) exposure to varicella

ICD9

  • 052.9 Varicella with...

CLINICAL PEARLS

  • Varicella zoster infection is more likely to produce serious illness in adults than in children.

  • Introduction of the varicella vaccine has reduced morbidity and mortality. Currently, 2 ...

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