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?