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PubMed1989

IgM and IgG responses to varicella-zoster virus p32/p36 complex after chickenpox and zoster, congenital and subclinical infections, and vaccination.

Varicella-zoster virus (VZV) directs the synthesis of a nonglycosylated polypeptide complex with two prominent species with relative molecular masses of 32,000 and 36,000; the p32/p36 complex is present in both the viral nucleocapsid and the nuclear matrix of the infected cell. We have now further characterized the humoral immune response of VZV-infected humans to this complex and established that it is a major viral antigen. Antibodies to VZV p32/p36 were detected in sera from patients with both primary VZV infection (chickenpox) and VZV reactivation (zoster); the response after zoster was more pronounced. When the IgM and IgG components of the immune response were distinguished, IgM to the viral nucleoproteins was observed following chickenpox and zoster and, to a lesser extent, in recipients of VZV vaccine. An IgM response to VZV p32 also was detected during intrauterine VZV infection and subclinical VZV infection.

Antibodies, Viral↗
PubMed1994

Occurrence of chickenpox during pregnancy in women seropositive for varicella-zoster virus.

In a group of 21 women counseled after exposure to chickenpox during pregnancy, 4 developed varicella despite initial studies showing that preinfection sera were varicella-zoster virus (VZV)-seropositive by fluorescent anti-membrane antibody, latex agglutination, ELISA, and VZV glycoprotein immunoblot assay. Further investigations showed that 2 of the 4 had low-titer (1/100), low-avidity, VZV-reactive IgG3 antibodies by ELISAs of preinfection sera. After chickenpox, these women developed primary-like serologic responses to VZV. Two women with high-titer (1/1600, 1/3200), high-avidity, IgG1 antibodies showed anamnestic serologic responses after reinfection. The criteria of protective VZV immunity remain ill-defined.

Adult↗
PubMed1998

Chickenpox monoarthritis: demonstration of varicella-zoster virus in joint fluid by polymerase chain reaction.

A case of chickenpox monoarthritis is described. The presence of varicella zoster virus (VZV) within the joint was demonstrated by the detection of viral DNA in synovial fluid at a time when peripheral blood cells were negative. This strongly suggests a direct role of VZV in causing monoarthritis complicating chickenpox. The use of the polymerase chain reaction allows more rapid (2 days) confirmation of the diagnosis. Early enough diagnosis would raise the question of using acyclovir to shorten the duration of arthritis.

Antibodies, Viral↗
PubMed2004

Septic arthritis of the elbow after chickenpox.

Musculoskeletal complications following chickenpox are rare among immunologically normal children. Septic arthritis after varicella is caused by group A Streptococcus and affects the knee most frequently. We present a case of septic arthritis of the elbow caused by Staphylococcus aureus. We review the English language literature on septic arthritis complicating chickenpox. We conclude that diagnosis and treatment should be carried out according to guidelines on de novo septic arthritis including the early use of magnetic resonance imaging.

Arthritis, Infectious↗
PubMed1985

Antibody response to varicella-zoster virus surface glycoproteins in chickenpox and shingles.

Varicella-zoster virus (VZV)-infected cell surface proteins were investigated using extrinsic radiolabelling of the cell surface, immunoprecipitation of detergent-solubilized extract of the same cell surface and fractionation of the immunoprecipitates using SDS-PAGE. Glycosylated proteins were identified by their affinity for Ricinus communis lectin. Six glycoproteins with apparent mol. wt. of 170K, 105K, 93K, 81K, 53K and 45K were identified. The 170K glycoprotein was shown to be disulphide-linked since under reducing conditions for SDS-PAGE it was cleaved to a protein of 63K mol. wt. The IgG responses to these glycoproteins during various clinical circumstances are described. In acute sera from all chickenpox patients and in the majority of acute shingles sera, antibodies reactive with glycoproteins could not be detected. In chickenpox convalescence, antibodies reactive with glycoproteins of mol. wt. 170K, 105K, 53K and 45K were identified, whilst during zoster convalescence antibodies to all six were prominent. Antibodies to the disulphide-linked glycoprotein persisted for many years following both the primary disease and its reactivation. Disseminated zoster was associated with significantly low levels of antibodies to these surface glycoproteins.

Adult↗
PubMed1990

Central nervous system vasculitis after chickenpox--cause or coincidence?

A 7.5 year old boy, known to have a seizure disorder, presented with an infarct in the left middle cerebral artery territory, 10 weeks after severe chickenpox. Immunofluorescent antibody titre to the varicella zoster virus in the cerebrospinal fluid was 1:32. Cerebral angiography showed evidence of focal vasculitis. He presented again seven months later with an acute exacerbation of seizures. Magnetic resonance imaging of the brain showed an old posterior extension of the infarct, but a repeated angiography demonstrated an improvement in the vasculitic process. Cerebrospinal fluid antibody titre was again 1:32. Although this may have been an unfortunate coincidence, a possible association between chickenpox and vasculitis, similar to that reported with herpes zoster, and with potentially significant clinical implications, should be considered. As a definite proof can be obtained only by a brain biopsy, however, which is generally not indicated in such cases, only additional clinical reports can lead to delineation of this association as a definite entity.

Brain Diseases↗
PubMed1995

Reactivation of chickenpox contracted in infancy.

Varicella zoster virus DNA in mononuclear cells was studied by the polymerase chain reaction to obtain virological evidence of reactivation in the children who had contracted chickenpox in infancy. The results appear to explain why chickenpox in infancy is a risk factor for herpes zoster in immunocompetent children.

Adolescent↗
PubMed1972

Malignant disease in children whose mothers had chickenpox, mumps, or rubella in pregnancy.

To test the hypothesis that leukaemia may follow virus infection in pregnancy an analysis was made of deaths which occurred in a cohort of children born in 1951 and 1952 after pregnancies in which the mothers suffered virus infections-chickenpox or mumps at any stage of gestation or rubella in the first 18 weeks. All deaths which occurred between the children's second birthday and the end of 1971 were studied.Two deaths from leukaemia occurred among the children whose mothers suffered from chickenpox, a significant excess. There were no deaths from leukaemia among the other children, but the causes of the two deaths after maternal mumps-Ewing's tumour and Still's disease-are noted because of their rarity.

Acute Disease↗
PubMed2001

Lung function tests and risk factors for pneumonia in adults with chickenpox.

BACKGROUND: Varicella is 25 times more likely to be complicated by pneumonia in adults than in children. Data on changes in lung function following pneumonia are limited. This study was undertaken to describe the epidemiological factors associated with pneumonia and to investigate lung function up to 1 year following chickenpox. METHODS: Thirty eight consecutive suitable patients admitted to a university hospital were enrolled in the study; 19 had pneumonia and 19 did not. Epidemiological data and density of rash were recorded, spirometric tests were performed, and carbon monoxide transfer factor was measured. RESULTS: Varicella pneumonia was associated with the presence of respiratory symptoms (p=0.006), current smoking (p=0.003), and history of close contact (p=0.009). There was a trend towards patients with pneumonia having a more severe rash. No association was observed between pneumonia and age or sex. Current smokers had a higher mean number of spots than non-smokers (p=0.005). Carbon monoxide transfer factor at hospital discharge was reduced in 27 patients (71%), more markedly in the group with pneumonia (p=0.009). Nine patients (seven with pneumonia) still had a reduced carbon monoxide transfer factor (mean reduction 36%) at 12 months. CONCLUSION: Chickenpox may result in a defect in carbon monoxide transfer factor for at least a year after acute illness.

Adult↗
PubMed1988

Chickenpox pneumonia: experience with antiviral treatment.

Of 13 patients with chickenpox pneumonia (12 of them adults) treated during 1979-87, 10 received antiviral drugs--nine acyclovir and one vidarabine. Three died despite intensive treatment. Serious secondary infections occurred in six cases. There were no clear indications that antiviral treatment altered the natural history of the condition. Acyclovir may at present be used too late in the course of chickenpox pneumonia to alter its outcome.

Acyclovir↗
PubMed1995

Fatal chickenpox pneumonia in an asthmatic patient on oral steroids and methotrexate.

A 49 year old man with a long history of severe chronic asthma, treated with oral corticosteroids and weekly doses of methotrexate, contracted chickenpox from his son whose chickenpox rash had developed three weeks before presentation. Five days before admission the patient developed a vesicular skin rash which became extensive, with general malaise, bilateral pneumonia, and acute deterioration of his asthma. He died two weeks after admission despite treatment with acyclovir.

Acyclovir↗
PubMed1992

Abscess formation as a complication of chickenpox.

Chickenpox is a common infectious disease of childhood. Skin lesions may occasionally become secondarily infected with bacteria. Large abscess formation is reported complicating a mild case of chickenpox in a previously healthy patient.

Abscess↗
PubMed2005

Precipitation of stroke-like event by chickenpox in a child with MELAS syndrome.

The mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes syndrome (MELAS) is a rare congenital disorder of mitochondrial DNA (mtDNA). Herein we report a case of MELAS, whose second stroke-like episode was provoked by chickenpox. A point mutation at nucleotide (nt) 3243 in mtDNA supported the diagnosis of MELAS in this case. History of myopathy, the presence of lesions that did not conform to accepted distributions of vascular territories on cranial magnetic resonance imaging (MRI), normal result of cranial magnetic resonance angiography, hyperintensity on diffusion weighted MRI and apparent diffusion coefficient mapping indicating the presence of vasogenic edema in the fresh stroke-like lesion, and mitochondrial DNA analysis helped to exclude the diagnosis of ischemic cerebral infarction which can also be induced by chickenpox.

Chickenpox↗
PubMed1984

Varicella-zoster immune globulin for the prevention of chickenpox. Recommendations of the Immunization Practices Advisory Committee, Centers for Disease Control.

This is the first statement by the Immunization Practices Advisory Committee on the use of varicella-zoster immune globulin ( VZIG ). Prior recommendations have been made by the manufacturer in cooperation with the Centers for Disease Control and approved by the Office of Biologics, National Center for Drugs and Biologics, U.S. Food and Drug Administration. Because of exceedingly limited supplies, VZIG use has been restricted to proven high-risk individuals--for prophylaxis against chickenpox in immunocompromised children and prevention of postnatal chickenpox following intrauterine exposure. With increasing supplies, some of these restrictions can be lifted. This statement includes use of VZIG for immunocompromised persons of any age, normal adults, pregnant women, and premature and full-term infants. However, because the supply of VZIG is still limited, it continues to be recommended primarily for immunocompromised children and certain neonates exposed in utero. It should not be used indiscriminately.

Adolescent↗
PubMed2000

Chickenpox increasingly affects preschool children.

Between 1983 and 1998, age specific incidences of chickenpox derived from consultations with general practitioners taking part in the Royal College of General Practitioners Weekly Returns Service doubled in children aged 0 to 4 years, halved in children aged 5 to 14 years, and fell by almost a third in adults aged 15 to 44 years. This downward shift in age of contracting chickenpox may be a result of increased social contact between preschool children.

Adolescent↗
PubMed2000

Acute retinal necrosis syndrome complicating chickenpox.

Chickenpox may be complicated by ocular involvement. In these patents, acute retinal necrosis usually forms a relatively mild course. Systemic antiviral treatment during the acute phase of the disease is recommended. Rarely, retinal detachment may develop, resulting in blindness. It is strongly recommended that patients with chickenpox who develop visual symptoms should be referred for an ophthalmological opinion early.

Acyclovir↗
PubMed2001

[Arterial hypertension, hematuria and renal involvement before chickenpox].

Chickenpox in childhood is usually a self-limiting disease with relatively few and benign complications, although serious complications do occur. Renal involvement is uncommon during the course of this disease. We describe a 6-year-old girl who developed clinical glomerulonephritis, with arterial hypertension, hematuria and transient minor disturbance of renal function revealed by creatinine clearance 2 days before the appearance of papulovesicular skin lesions characteristic of chickenpox. The patient recovered spontaneously in 2 weeks.

Chickenpox↗