Chickenpox in children: symptoms, treatment, complications, prevention
The content of the article:
- Characteristics of the pathogen
- Chickenpox pathogenesis
-
How does chickenpox begin in a child
- Rash development
- Symptoms of chickenpox in children
- Diagnosis of chickenpox
-
Treatment of chickenpox in children
Prevention of secondary bacterial infection
-
Complications of chickenpox in children
- Chickenpox encephalitis
- Rare complications of chickenpox
- Prevention of chickenpox
- Video
Chickenpox in children is most common between the ages of 6 months and 7 years. In some countries, the annual infection reaches fertility values. Therefore, throughout life, almost everyone has antibodies to Varicellavirus. The activity of the disease occurs in the September-March season (due to the closer contact of children with each other in groups).
Chickenpox in children can occur with varying degrees of severity of symptoms
Chickenpox is an acute infectious highly contagious disease caused by the herpesvirus Varicella zoster, which is characterized by maculopapular vesicular rash. It is considered the most common infection on the planet.
A peculiarity of the pathogen is that after the disappearance of the clinical manifestations, the varicellavirus remains in a dormant mode for the rest of its life in the cells of the nervous tissue and, when activated, causes reinfection, called herpes zoster.
Ways of transmission of the pathogen of chickenpox:
- drip: ingestion of particles of the virus when sneezing through saliva or nasal secretions from patients with rashes on the mucous membranes;
- contact: during direct contact with the elements of the rash or items of clothing of the patient;
- vertical: the penetration of the virus intrauterinely through the placenta to the fetus.
Characteristics of the pathogen
The spread of infection is a patient with chickenpox and herpes zoster.
The causative agent of chickenpox is the Varicella zoster virus
The pathogen is unstable in the environment, dies under the influence of sunlight, heating, ultraviolet radiation, and can be easily neutralized with disinfectants. Moreover, it remains viable for a very long time at low temperatures. Outside the body, Varicellavirus is viable for 30 minutes.
Once in the body, the virus exhibits tropism (the ability to penetrate and multiply) to the epithelium of the mucous membrane of the oropharynx, skin and nervous system, which causes a specific clinical picture.
A person's susceptibility to this virus exceeds 95% (9 out of 10 people who have come into contact with the source of the virus develop chickenpox). Children in the first 6 months of life are immune to the virus, provided that the mother has been ill or has been vaccinated against Varicellavirus. The maximum number of cases occurs at the age of 2–4 years (approximately 80%).
Chickenpox pathogenesis
During the period called incubation, Varicellavirus, getting on the mucous membrane of the nasopharynx, quickly penetrates the DNA of the epithelial cell, multiplies and accumulates in them. Pathogens, gradually increasing in number, reach the lymph nodes, where they actively multiply for 4–6 days.
Varicellavirus enters the body through the nasopharyngeal mucosa
From the lymph nodes Varicella zoster is released into the bloodstream, with its current it spreads throughout the body, reaching the skin and the nervous system.
Vivid clinical signs arise in response to the entry of Varicellavirus into the blood. By affecting skin cells, the virus causes capillary expansion and blemishes. Then swelling grows, papules are formed. After the epidermis is detached, they turn into vesicles (vesicles with a liquid center).
The child's immune system is able to cope with all viruses, except those that have entered the cells of the nerve ganglia. It is there that the infection can be in a dormant state for decades, activating under the influence of provoking factors that reduce the overall resistance of the body:
- severe infectious diseases;
- overheating or hypothermia;
- prolonged exposure to the sun;
- stress;
- hormonal imbalance;
- severe pathology (leukemia, tumors, HIV);
- therapy with glucocorticosteroids, cytostatics, immunosuppressants.
How does chickenpox begin in a child
From the moment of meeting with a patient with chickenpox until the development of symptoms, it takes from 5 to 21 days (mostly up to 14).
The symptoms of chickenpox in children can be conditionally divided into two groups:
- intoxication;
- damage to the skin and mucous membranes.
The disease begins suddenly with a rise in body temperature (the higher the indicator, the harder the process will be). The fever can last 2-7 days. Some children complain of weakness, decreased appetite, and drowsiness.
The rash begins to appear already on the first day of the fever. Chickenpox is characterized by polymorphism of changes on the skin (all stages of rash development will be present at the same time).
Rash development
Stages of rash development:
- Macula (speck). Local expansion of blood vessels. It looks like a red dot, disappears when you tap on it with your finger, and quickly reappears.
- Papula. In the center of the speck, the skin rises due to edema.
- Vesicle. It is considered the hallmark of chickenpox. In the center of the papule, a bubble appears, filled with a clear liquid. It has a round shape, dense with a thin tire, looks like a dewdrop. Over time, the bubbles lose their shape, flatten, the liquid inside becomes cloudy. They become soft, easily destroyed.
- Crust. Drying begins from the center of the vesicle. The crust is brownish-brown, dense, easily removable. In its place, over time, no trace remains, provided that a bacterial infection has not been introduced.
Rashes usually appear under the scalp hair. First, several vesicles appear, then their mass appearance begins. In the future, the skin on the trunk, arms and legs is quickly affected. In addition to the skin, the rash develops on the mucous membrane of the mouth, nasopharynx, less often - the conjunctiva, larynx, genitals.
The disease is characterized by the staging of skin manifestations: a new portion of the rash appears after the previous one matures (on average, once every 1-2 days). Each wave of dripping is accompanied by a rise in body temperature and intense itching.
Symptoms of chickenpox in children
Depending on the severity of the disease, the following symptoms may appear:
| Chickenpox flow shape | Features: | Possible consequences |
| Easy | The general condition is not disturbed, the body temperature is normal, there are single elements of the rash on the body | The likelihood of complications is extremely low. There are cases of repeated chickenpox disease |
| Medium | Fever persists for 5–7 days at 38–39 ° C. The rash is present primarily on the skin | Complications are usually absent |
| Heavy | Severe intoxication, fever persists for more than 1 week. Profuse rash on the skin and mucous membranes | Often complicated by the addition of a secondary infection, pneumonia, encephalitis |
| Hemorrhagic | Against the background of a severe course of chickenpox, there is a bloody content inside the vesicles | Hemorrhages on the skin and mucous membranes, bleeding from the nose, uterus, gastrointestinal tract are often associated |
| Bullous | Against the background of a normal rash, large flaccid blisters with purulent contents appear | Accession of a bacterial infection, sepsis |
| Generalized | Extremely severe course with damage to the lungs, liver, spleen, pancreas | Scarring of the skin. Mortality exceeds 20% |
Severe forms of chickenpox mainly develop in children with concomitant pathology:
- blood cancer;
- malignant neoplasms;
- tuberculosis;
- taking cytostatics, immunosuppressants;
- long-term hormone therapy;
- congenital immunodeficiency.
Diagnosis of chickenpox
The doctor does not have any difficulties in determining the diagnosis. The pediatrician, even according to the survey and examination, understands what the matter is. Varicellavirus has vivid clinical symptoms, characteristic staging and rash.
In the clinical analysis of blood during the disease, leukopenia (a reduced number of leukocytes) and lymphocytosis (an increased content of lymphocytes) are observed - typical signs of any viral disease.
In controversial cases, Varicella zoster infection will be determined by:
- a blood test for the presence of immunoglobulins (IgA, IgM, IgG) to the chickenpox virus;
- isolation of virus DNA from the elements of the rash or cerebrospinal fluid by PCR (polymerase chain reaction).
Treatment of chickenpox in children
Children with healthy immune systems and mild chickenpox are treated at home. It is advisable for such patients to prescribe only symptomatic therapy - drugs for fever and itching.
In severe disease, Acyclovir is prescribed
Acyclovir is an etiotropic (capable of destroying the pathogen) drug for the treatment of chickenpox.
Indications for the appointment of Acyclovir:
- patients with chickenpox over 12 years old;
- the presence of malignant neoplasms;
- patients who received a bone marrow and other organs transplanted;
- patients on long-term glucocorticosteroid therapy;
- people with immunodeficiency;
- children with congenital Varicella Zoster infection;
- complications of chickenpox;
- severe course of chickenpox.
The dose of Acyclovir is determined based on body weight. It is necessary to start taking the drug as early as possible (optimally - on the first day of the illness). The duration of treatment is up to 48 hours from the moment of the last dripping.
For local treatment, agents with antiseptic and antipruritic effects are used, for example, Tsindol
For local treatment of itching, the following are used:
- Calamine lotion;
- Chlorphenamine;
- Tsindol;
- Poksklin.
Prevention of secondary bacterial infection
Prevention of secondary bacterial infection includes:
- maximum preservation of the integrity of the vesicles;
- daily replacement of underwear and bed linen;
- painting of rashes with aniline dyes (potassium permanganate, brilliant green, fucorcin).
Complications of chickenpox in children
The incidence of complications in chickenpox in previously healthy patients ranges from 5 to 25% (in children with immunodeficiency - up to 50%). Kids, unlike adults, suffer from the disease in a milder form.
The first place in prevalence is occupied by the addition of a secondary bacterial infection:
- pyoderma;
- stomatitis;
- skin abscess;
- lymphadenitis;
- gastroenteritis;
- bronchitis;
- viral pneumonia;
- otitis media;
- conjunctivitis;
- urinary tract infection;
- sepsis;
- bacterial meningitis.
The main causative agents of purulent complications are streptococcus and staphylococcus.
In second place in terms of prevalence is the defeat of the nervous system by Varicellavirus:
- febrile seizures;
- acute cerebellar ataxia;
- meningitis;
- encephalitis;
- vasculitis.
Chickenpox encephalitis
This is the most common neurological complication of chickenpox. Signs of involvement in the process appear 5–10 days after the rise in body temperature, more often in preschool boys.
In some cases, neurological complications develop
Against the background of a high temperature, a child may have:
- persistent, growing headache;
- increased sleep duration;
- lethargy or psychomotor agitation;
- dizziness;
- violation of coordination of movements.
In severe cases, epileptic seizures, Guillain-Barré syndrome, coma develop.
Consequences of encephalitis:
- mental retardation;
- stroke;
- hemiparesis;
- paresis of the optic or facial nerves;
- hypothalamic syndrome.
Rare complications of chickenpox
Rare complications of chickenpox include:
- thrombocytopenia: with bleeding from the nose, stomach, intestines, blood in the urine, hemorrhages in the skin;
- chickenpox: swelling of the larynx affected by the rash that causes respiratory distress;
- liver damage: due to the multiplication of the virus inside hepatocytes;
- nephritis: kidney damage accompanied by hypertension, edema, and blood in the urine.
Prevention of chickenpox
A child with chickenpox remains dangerous to others for up to the fifth day after the last portion of vesicles has been poured.
Vaccination is an effective prevention of chickenpox
Today, clinics have a live vaccine against chickenpox. This vaccination is included in the vaccination calendar as recommended. It is indicated for children over one year old who have not had chickenpox. Two doses are administered intramuscularly with a break of 6–8 weeks. Immunity is life-long.
According to Dr. Komarovsky, parents should know how chickenpox begins. They need to study the photo, read the explanation of where the rash may appear and a description of the stages of its development. It is important to ask the pediatrician how to recognize the disease and treat the child, preventing secondary infection and spread of the disease.
Video
We offer for viewing a video on the topic of the article.
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
Found a mistake in the text? Select it and press Ctrl + Enter.
