Varicella Complications in Children and Adults
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Questions and Answers

What is the overall risk of congenital varicella syndrome when maternal varicella occurs during the first 20 weeks of gestation?

  • 2%
  • 1% (correct)
  • 10%
  • 5%
  • Which statement regarding perinatal varicella is accurate?

  • It is more serious than varicella in infants infected a few weeks later. (correct)
  • It can occur without maternal symptoms.
  • It primarily affects the respiratory system.
  • It poses a lower risk than varicella in infants infected weeks later.
  • What complications are commonly associated with severe varicella in immunocompromised patients?

  • Severe cerebral edema
  • Pneumonia and hepatitis (correct)
  • Rash and mild fever
  • Localized skin infections
  • Acute cerebellar ataxia is noted in what proportion of varicella cases?

    <p>1 in 4,000 cases</p> Signup and view all the answers

    Which of the following is a rare complication of varicella?

    <p>Myocarditis</p> Signup and view all the answers

    What is the most common complication of varicella in children?

    <p>Secondary bacterial infection of skin lesions</p> Signup and view all the answers

    What percentage of invasive group A streptococcal infections were associated with varicella before widespread vaccination?

    <p>15% to 30%</p> Signup and view all the answers

    Which symptom is NOT typically associated with varicella pneumonia in adults?

    <p>Nasal congestion</p> Signup and view all the answers

    How does varicella pneumonia affect mortality rates in adults?

    <p>The mortality rate varies between 10% and 30% depending on treatment.</p> Signup and view all the answers

    What risk does varicella pose during pregnancy?

    <p>It can result in maternal death or complications but not significantly increase fetal mortality.</p> Signup and view all the answers

    Study Notes

    Varicella Complications in Children

    • Rarely complicated in healthy children; most common complication is secondary bacterial infection of skin lesions.
    • Staphylococci and Streptococci can lead to conditions like impetigo, cellulitis, and erysipelas; rare cases of necrotizing fasciitis.
    • Local infections can cause scarring and, in rare instances, septicemia or metastatic infections.
    • Bullous lesions may arise from Staphylococcal superinfection of vesicles, producing exfoliative toxins.
    • Invasive group A Streptococcus infections are a notable complication, occurring within two weeks of the rash; historically constituted 15%-30% of invasive infections linked to varicella, now reduced to 2% due to vaccination.

    Varicella Complications in Adults

    • Adults experience more pronounced and extended fever and symptoms; rash is more extensive.
    • Varicella pneumonia is a significant severe complication in adults, presenting with cough, dyspnea, tachypnea, high fever, pleuritic chest pain, cyanosis, and hemoptysis within 1 to 6 days post-rash onset.
    • Imaging usually shows diffuse nodular densities in lung fields; severity often outweighs physical findings.
    • Mortality rate for varicella pneumonia in adults is estimated between 10%-30%, dropping below 10% with prompt antiviral treatment, especially in non-immunocompromised patients.

    Varicella During Pregnancy

    • Presents threats to both mother and fetus; severe pneumonia can lead to maternal death.
    • Incidence and severity of pneumonia do not significantly increase due to pregnancy.
    • Fetal risks include premature labor and congenital varicella syndrome, which occurs in about 1% of cases when maternal infection happens in the first 20 weeks, peaking at 2% between 13-20 weeks.
    • Perinatal varicella (within 10 days of birth) poses a higher risk compared to infections occurring later in infancy.

    Varicella in Immunocompromised Patients

    • Higher morbidity and mortality rates due to prolonged viremia and extensive rash.
    • Common symptoms include severe abdominal and back pain; complications may include pneumonia, hepatitis, encephalitis, and hemorrhagic conditions like purpura fulminans.
    • Neurological complications include acute cerebellar ataxia (occurring in 1 in 4000 cases, generally with good prognosis) and less common encephalitis (1 per 33,000 cases) which may lead to death or long-term neurological issues.
    • Clinical hepatitis is rare except in immunocompromised patients; other rare complications include myocarditis, glomerulonephritis, orchitis, pancreatitis, and various allergic vasculitides.

    Miscellaneous Complications

    • Reye syndrome linked to varicella has become rare due to restriction of salicylate use in children.
    • While mildly elevated aminotransferase levels are typical during varicella, significant liver complications are uncommon.
    • Possible rare complications also include optic neuritis, keratitis, and ulcerative lesions of the bowel.

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    Description

    This quiz covers the complications associated with varicella (chickenpox) in both children and adults. It highlights the common and rare complications, including bacterial superinfections and severe respiratory issues in adult patients. Test your knowledge on this important topic related to infectious diseases.

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