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Paeds - Systemic > VZV > Flashcards

Flashcards in VZV Deck (10):
1

When is a case of VZV most infectious? When are they infectious until?

- most infectious during prodrome
- Infectious from one to two days before the onset of the rash until the lesions have fully crusted over (i.e. fully dried)

2

What is the natural history of VZV? Progression of rash?

• Prodrome: fever, malaise, anorexia
• Rash day 3-5:
• Pruritic macules - papules - vesicles - umbilication - crusting
• Central (Scalp, face, trunk)
• Fully crusted lesions by day 10

3

How is VZV spread

- Spread by direct contact/droplet spread

4

When is vaccination recommended?

- Recommended for >12mo and seronegative adults

5

When are complications more common with VZV, and what are the possible complications?

More common in infants, >15yo and IC pts:
• bacterial superinfection (particularly group A beta haemolytic streptococcus and Staph aureus)
• Pneumonia
• Encephalitis
• Cerebellitis
• Hepatitis
• Arthritis
• Reye syndrome

6

What can VZV recur as?

- Herpes zoster (shingles) – can occur > 1 dermatome in kids, post-herpetic neuralgia less common.

7

What kind of post-exposure Tx is there fore VZV? When is it given? Who is it recommended for?

• Zoster immunoglobulin
• Give within 96 hours of exposure
• For:
○ Pregnant women
○ Neonates whose mother develops varicella from 7 days before to 2 days after delivery.
○ Immune deficiency

8

What infection precautions should be taken in VZV?

- Must be notified within 5 days of varicella diagnosis in Victoria
- No school until fully recovered (all lesions crusted over) or at least one week after the eruption first appears
- Any admitted child with active chickenpox or zoster should be isolated
- Cut nails short at first sign of disease - scratching increases risk of 2ndary bacterial infection

9

What is the Mx of VZV in an immunocompetent child?

Symptomatic:
- hydrate
- Calamine lotion, cool compresses
- Possible oral anti-histamines to improve sleep
- Paracetamol for fever, not aspirin

10

When does the Mx of VZV differ, and how does it differ?

- Mx in immunocompromised/certain neonates (i.e. <28d)/severe eczema
- IV aciclovir