Varicella Flashcards
(32 cards)
90% of cases occur in what pop
children below 10 yo.
highest age spec incidence in age 1-4 yo unvaccinated children.
incu period
10-21 days usually 14-15 days
infectious days, or when is it communicable
5 days before eruption
most infectious 1-2 days before rash.
days or secondary viremia
day 11-20
days for infection of RES
bet day 4-6
mortality rate in children
1.4 in 100,000 cases
adults: 30.9 in 100,000 cases.
preg women 5x greater risk of an adverse outcome
vesicles char as
tear drop vesicles on an erythemtous base
most common complicarion of varicella
sec infec w s aureaus and strep
most comm neuro complications
Cerebellar ataxia
encephalitis
Vari- CE
skde effect if using aspirin in varicella
Reye syndrome
hepatitis
acute enceph.
Varicella/ Asp/ ReAcHe
drug contraindicated in vari
Aspirin
dx
tzanck smear from a vesicle . show
multinucleate giant cells.
DFA can confirm the infection and type the virus.
tx
acyclovir w in 24 hours of eruption.
aspirin is 20mg/kg max 800 mg per dose 4x a day for 5 days.
tx for severe fulminant cutaneous disease and visceral complications
IV acyclovir 10mg/kg every 8 hours adj for crea clearance
if maternal infection occurs before 28 weeks Aog and slex before 20 wks a small bubsig risk of infection of fetus called
congential varicella syndrome
Hypoplastic limbs
Cutaneous scars
Ocular and CNS disease.
female >male fetus
0.4 % overall risk
highest risk in varicella occ at weeks 25-36 w AOG.
risk of spont abortion by 20 weeks
3%
fetal death occurs after 20 wks.
severe vari and vari pneumo or disseminated dx in preg tx
IV acyclovir
all varicella in preg tx
oral acyclovir 800mg 5x a day for 7 days. adj renal func.
tx for all women past 35 wks of gestation or w inc risk of premature labor;
admission and IV acyclovir 10mg/kg 3x a day.
when is VZIG given
not in pregnant women who has dev varicella.
given for significant exposures within the first 72-96 hours
congenital varicella syndrom anmalies
hupoplastic limbs usually unilateral and lower ext
cutaneous scars
ocular and cns disease.
highest risk in maternal varicella congenital syndrom
2% from maternal varicella bet weeks 13 and 20.
overall risk for congential varicella syndrome- 0.4%
how many days before and after delivery that pxs has varicella that has the possibility of having neonatal varicella
5 days before and 2 days after delivery
HIV tx for varicella
Valacyclovir 1g 3x a day
famciclovir 500mg 3x a day
acyclovir 800mg 5x a day.
if no visceral complications
valacyclovir and famciclovir may be preferable to acyclovir bec of enhanced oral bioavailability.
