Oral acyclovir for chickenpox.
We report on our experience with acyclovir (Zovirax) capsules for the symptomatic treatment of chickenpox in two children and an adult.
Acyclovir↗
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Concurrent smallpox and chickenpox.
Three patients showing smallpox- and chickenpox-like lesions simultaneously were investigated virologically. Both infections were confirmed in the laboratory and, in one case, by electron microscopy.
Adolescent↗
[Quantification of bacteria in the small intestine of malnourished children with chickenpox].
The purpose of the present study was to determine whether a high number of bacteria could be demonstrated in the upper small bowel during the chickenpox infection. Intestinal juice was drawn in nine malnourished children, during and two weeks after the acute period of the disease. The results of the study fail to demonstrate quantitative differences in the bacterial flora of the small bowel in both periods. Besides that, the bacterial overgrowth previously reported in malnutrition, is confirmed.
Bacteria↗
Measles, mumps, rubella and chickenpox in the adult population.
The common "childhood diseases" of measles, mumps, rubella and chickenpox do appear in the adult population. It is important for health care practitioners to recognize these diseases in adults and be alert for possible complications which may be more serious than those found in children. This article discusses epidemiology, transmission, signs and symptoms, treatment, possible complications, confirmatory tests and immunization recommendations for each of the four diseases.
Adult↗
Evaluation of a combined measles-mumps-rubella-chickenpox vaccine.
There was neither a difference in the (low) percentage of only harmless side-reactions nor in the rate of sero-conversions (between 95-100%), when groups of 15 to 24 months old children were vaccinated either with the single components or with a combined MMR + Chickenpox-vaccine of a high potency.
Antibodies, Viral↗
[Epidemiology of herpes zoster. The herpes zoster patient as a source of infection with chickenpox].
The authors analyse the inpatient findings accumulated from 2,179 observations on herpes zoster cases for 10 years. The clinico-epidemiological characterization of herpes zoster patients as the potential source of chickenpox infection is presented. The clinical data speak for the droplet transfer of the agent (varicella zoster virus) in this infection, which has permitted the formulation of exact practical recommendations of quarantine and isolation measures in the focus of herpes zoster.
Acute Disease↗
Risk of herpes zoster in children with leukemia: varicella vaccine compared with history of chickenpox.
A study was undertaken to determine whether children immunized with live varicella vaccine are at greater risk of acquiring herpes zoster than children who have had varicella. Children with acute lymphocytic leukemia who had had varicella were compared with those who received live varicella vaccine. During the period of observation, 15 of 73 children who had varicella acquired herpes zoster and none of the 34 children who had been vaccinated. If the time of observation was adjusted for and the vaccinees who failed to have a sustained antibody response or who acquired chickenpox were removed, the risk of herpes zoster was still less in vaccinees (P = .0075). Because herpes zoster is common in children with acute lymphocytic leukemia, differences in the two groups could be discerned more readily than if normal children were compared. There is no reason to suspect that recipients of live varicella vaccine would be more likely to acquire herpes zoster than children who get varicella.
Adolescent↗
[Chickenpox and pregnancy. Perinatal aspects and prevention].
Five neonates born to women who had had varicella late in pregnancy or in the post-partum were admitted to our unit during the last year. In utero transmission of varicella-zoster virus occurred in 2 cases. One of them had no clinical eruption but specific IgM at a titer of 1/200. The mother presented with varicella 15 days before delivery. The other developed severe neonatal congenital varicella (with disseminated eruption, pneumonia and seizures). She was treated by Aciclovir (15 mg/kg/8 h). The mother presented with chickenpox 24 hours after birth. Varicella occurring in a pregnant woman from 4 days before to 2 days after delivery is dangerous because the baby will lack maternal antibodies. It may develop severe neonatal varicella (mortality: 20-30%). A neonate in critical condition was successfully given a prophylactic treatment by Aciclovir IV (15 mg/kg/8 h for 5 days) and varicella-zona immunoglobulins (2 ml on days 1, 2, 3). This approach may be the best treatment for babies at risk for severe neonatal varicella.
Chickenpox↗
[Chickenpox, burns and grafts].
An outbreak of chickenpox that occurred at the Burns Repair Surgery Unit, Department of Children's Surgery, Hospital R. del Río, between June and November, 1975, is reported. 27 cases of burned children were studied, including analysis of correlations of the stages and outcome of the disease (varicela), the trauma (burns) and the graft (repair surgery). As a result, the authors emphasize the following findings: 1. Burns and their repair are not aggravating factors for varicella. In a small number of cases the exanthema looked more confluent in the graft surgical areas and in the first degree burns healing spontaneously. 2. Usually there was an uneventful outcome of graft repair surgery on a varicella patient, either during the incubation period, the acme or the convalescence. 3. The fact that the outmost intensity of secondary viremia of varicella occurs before the onset of exanthemia, that is, during the late incubation period, is confirmed.
Burns↗
Central nervous system manifestations of chickenpox.
A study of 57 cases of affection of the central nervous system associated with chickenpox diagnosed and treated at The Hospital for Sick Children in Toronto between 1956 and 1967, inclusive, is presented. The commonest type, the cerebellar variety (50%), had an excellent prognosis. In the next commonest, the cerebral type (40%), the mortality rate was 35% but there was a low incidence of permanent sequelae in the surviving patients. A small group classed as aseptic meningitis was defined and one case of myelitis was reviewed.
Brain Diseases↗
Chromosomal studies in children with mumps, chickenpox, measles and measles vaccination.
A study to assess chromosomal damage in persons with acute viral diseases was undertaken in view of conflicting reports in the literature concerning such damage. Forty children with measles, mumps, and chickenpox, or who had received measles vaccine, were investigated and compared with a control group of 12 children. No greater incidence of chromosomal abnormalities was found in the study group than in the control group.
Adolescent↗
Uveitis and ophthalmoplegia complicating chickenpox.
Two cases of unilateral uveitis which appeared in association with chickenpox are presented. In one of them internal ophthalmoplegia was seen. Possible pathogenic mechanisms are discussed. The unusual cycloplegia which was present in one case can be caused by viral lesion to the ciliary nerves.
Chickenpox↗
[Complications of chickenpox].
A patient with typical varicella (chickenpox) developed several complications: nephrotic syndrome following glomerulonephritis, trombocytopenic purpura, gastrointestinal bleeding, disseminated intravascular coagulation, encephalitis and bronchopneumonia. The course was satisfactory having been given antibiotics, heparin and peritoneal dialysis. Recovery was 100%.
Anti-Bacterial Agents↗
Chickenpox encephalitis and encephalopathy: evidence for differing pathogenesis.
Retrospective assessment of hepatic and central nervous system involvement associated with chickenpox cases at a large metropolitan medical center reveals that 28 of 58 patients had biochemical, but not inflammatory, evidence of liver involvement. An additional 18 patients had biochemical liver abnormalities along with non-inflammatory encephalopathy (Reye syndrome) and 12 had clear evidence of central nervous system inflammatory involvement (encephalitis). There were no cases of solitary inflammatory liver involvement. Reviewed evidence suggests that the pathogenesis of hepatopathy and hepatoencephalopathy (Reye syndrome) is not caused by replication of virus in the involved organs, but instead is mediated through a cytotoxic mechanism and that the inflammatory brain disease is also not caused by viral replication in brain tissue, but appears to be tissue damage associated with immune cell responses (post-infectious encephalitis). The concept put forth in this essay is that a virus replicating in one organ (skin) could affect the macromolecular function of cells in another organ (liver, brain) bringing about both hepatopathy and hepatoencephalopathy.
Brain↗
[Neuromyelitis optica or Devic disease complicating chickenpox (author's transl)].
In a 8 year-old girl, chickenpox was complicated with opticomyelitis (Devic's disease). In adults, opticomyelitis is often considered as closely related to multiple sclerosis; in children an infectious etiology must be investigated first.
Chickenpox↗
[Suppurative complications of chickenpox in children].
In 1979-1990 213 children with local (n = 155) and generalized (n = 58) purulent complications of chickenpox, developing on days 2-6 after the eruptions, underwent treatment. They occurred mostly in children aged from 12 months to 3 years. Treatment of local forms caused no difficulties and was successful in all cases. A very severe course was encountered in 25 children with the development of ligneous phlegmon and toxico-infectious shock; 6 of them died. The extent of the lesion in these cases included more than 10% of the skin surface. The treatment consisted in multiple incisions, the prescription of antibiotics in maximal doses, and immunostimulating and infusion therapy.
Anti-Bacterial Agents↗
Deep hand infection complicating chickenpox in an otherwise healthy infant.
Chickenpox is a common childhood infection, and complications are rare in the healthy child. This report describes a significant complication of varicella in an otherwise healthy infant.
Cellulitis↗
Necrotising soft tissue infections as a complication of chickenpox.
Varicella gangrenosum, in which a necrotising soft tissue infection complicates the vesicular eruption of chickenpox, is rare. The condition may have devastating sequelae including disseminated intravascular coagulation and death. Survival is dependent on early diagnosis, adequate antibiotic coverage and, particularly, early surgical debridement. Three cases of varying severity are presented here together with a review of the available literature.
Adult↗