Chickenpox, or chickenpox, is included in an extensive group of acute diseases with airborne transmission. It is caused by herpesvirus human type 3. This virus is not only the cause of chickenpox, but also herpes zoster. Chickenpox are sick mainly in childhood. Pathology in adults is rare and is usually characterized by a more severe course. The occurrence of complications of chickenpox in adults is determined by the state of immunity and the presence of comorbidities. Adequate and timely treatment is the key to recovery. Specific prevention is carried out with the help of vaccination.
More often, children under the age of 7–10 years get sick, the course of the disease is usually mild, adults rarely get sick.
The virus, entering the body, is introduced into the mucous membranes of the upper respiratory tract, enters the bloodstream and is fixed in the skin. The temperature rises, nonspecific manifestations of infection appear: weakness, pain in the head, lumbosacral region. After 1-2 days, a rash appears on the face, scalp and torso: pink spots from 2 to 4 mm, turning into papules (nodules) after a few hours, and then into vesicles (bubbles). The last in 24–72 hours dry up with the formation of crusts, falling away in 2-3 weeks of illness.
For adults characterized by massive eruptions, the severity of general toxic phenomena and severe itching. A rash can appear on the mucous membranes of the oral cavity, conjunctiva, genital organs, which is accompanied by pain and the formation of erosion. The period of temperature increase lasts from 2 to 8 days, rashes - from 2 to 7–9 days. If complications do not develop, then recovery begins, and a strong immunity is formed.
In some cases, the pathogen can last for a long time in the human body, and after a while it becomes more active and causes herpes zoster.
Herpes Zoster (shingles)
When ingested, usually in a child or adolescent, the herpes simplex virus type 3 causes typical chickenpox. But in some cases, in the person who has recovered, he goes into a “sleeping” state and for a long time hides in the nerve cells, without causing any symptoms. The result of the activation of the virus under the influence of various provoking factors is the exit from the nerve cells, the advance along the nerve and the skin lesion.
The disease begins with general weakness and hyperthermia. In the course of the nerve trunks, often intercostal and trigeminal branches, first there is a slight itching and tingling, and then rashes appear: pink spots, passing in 3-4 days into nodules, and after a short time - into vesicles with transparent contents. The process is accompanied by an increase in regional lymph nodes. Gradually, vesicles burst, dry, forming crusts. Uncomplicated herpes zoster lasts from 3 to 4 weeks.
The typical course of chickenpox and shingles is not always observed.
Clinical forms of chickenpox
Chickenpox is usually benign. In some cases, the occurrence of severe clinical forms of the disease.
Generalized (visceral, disseminated)
It is characterized by high fever, severe intoxication, abundant rashes on the skin and mucous membranes, damage to internal organs.
It is rare, it is registered in persons with weakened immunity. The contents of the bubbles has a hemorrhagic, or bloody character. There are hemorrhages in the skin and mucous membranes, nose bleeds, vomiting with blood, hemoptysis, blood in the urine.
On the background of typical rashes appear bubbles up to 3 cm in diameter with a flabby tire and muddy contents. After opening the bubbles in their place are wet surfaces. The healing process can end with the formation of spots that have a brownish color.
With this type of disease, the contents of the vesicle suppurate. Because of this, elements of the rash do not disappear for a long time, pigmentation remains in their place for several weeks.
On the periphery of the vesicles with purulent contents, a zone of inflammation forms. Then scabs form at the site of blistering, after which the ulcers with areas of necrosis and undermined edges are found.
Atypical forms of chickenpox develop on the background of weak body resistance. Factors provoking a decrease in immunity are:
- medication (hormones, antibiotics, sulfonamides, antifungals, etc.),
- excessive physical and emotional stress,
- prolonged hypothermia
- malignant tumors,
- radiation exposure
- occupational hazards
- poor diet,
- alcohol abuse, smoking.
These factors cause severe forms of infection in both children and adults.
Complications after chickenpox
The development of varicella zoster occurs due to the effect of the virus itself and due to the addition of a secondary infection caused by various bacteria. The first, directly related to herpes virus, are called specific, the second - bacterial.
Tissues, systems and organs involved in the pathological process
Skin, subcutaneous fat
Streptoderma, or pyoderma (purulent lesion of the skin caused by streptococci), abscess (purulent inflammation of tissues with their melting and the formation of a delimited purulent cavity), phlegmon (diffuse purulent inflammation of cellular tissue spaces), erysipelas (infection of soft tissues), edema (infection of soft tissues), erysipelas (infection of soft tissues), edematous inflammation (diffuse purulent inflammation of cellular tissue spaces), erysipelas group A).
With the defeat of the oral cavity develops stomatitis, larynx - laryngitis, sometimes with signs of stenosis of the respiratory tract, eyes - conjunctivitis, ear - otitis.
Acute catarrh of the upper respiratory tract, laryngotracheobronchitis, pneumonia. The course of pneumonia can be severe, with severe shortness of breath, cyanosis (bluish color of the skin and mucous membranes), the release of sputum mixed with blood.
central nervous system
Encephalitis (inflammation of the brain), encephalomyelitis (simultaneous damage to the brain and spinal cord). Encephalitis usually develops on the 4–7th day of the disease, when fever resumes, there is headache, vomiting, dizziness, unsteadiness of gait, incoordination, weakness of skeletal muscles, tremors (tremors) of the extremities.
In rare cases, the development of myocarditis (inflammation of the muscular layer of the heart), arthritis (inflammation of the joints), glomerulonephritis (kidney damage) is possible.
Consequences of varicella in pregnant women
Chickenpox disease during gestation is not an indication for abortion. The effects of chickenpox on the fetus depend on the period in which the pregnant woman has had the infection.
Gestational period at which the infection occurred
Consequences for the fetus
Up to 14 weeks gestation
Miscarriage is possible, teratogenic action - an effect on the fetus that disrupts embryonic development; however, the birth of children with developmental defects caused by chicken pox is very rare. When infected in this period, the risk of developing the pathology of the fetus is about 0.4–0.5%.
From 14 to 20 weeks
The probability of development of pathology in the fetus does not exceed 2%. Abortion is not marked.
After 20 weeks
The negative impact on the fetus is minimal, there is practically no risk to the child. Introduction of a specific immunoglobulin to a pregnant woman reliably reduces even this small chance of developing a pathology in the fetus.
10–14 days before delivery
The first clinical symptoms of the disease are detected immediately after childbirth. The course of infection is usually not very serious. This is because the mother has time to develop specific antibodies that get to the fetus through the placenta.
Immediately before giving birth
If a pregnant woman gets sick 4–5 days before delivery or just before the very birth, a congenital form of chicken pox can develop in a child with a probability of up to 17–20%. Congenital chickenpox is considered all cases of a newborn up to 11 days old. Typically, clinical signs appear on 5–10 days of a baby’s life. Pathology is characterized by a severe course, accompanied by bronchopneumonia, loose stools, damage to internal organs. According to statistics, every third case of the disease ends in death.
The method of specific prophylaxis, which allows to avoid the disease of chicken pox and herpes zoster, and therefore possible complications of these infections, is vaccination. Vaccination is included in the mandatory vaccination calendar in many countries and is carried out according to a specific scheme.
Children up to a year: 1 dose (0.5 ml) once.
Children from 1 year to 13 years: 1 dose (0.5 ml) twice with an interval between the first and second vaccination of 6-10 weeks. Adolescents over 13 years old and adults: 1 dose twice with an interval of 6-10 weeks.
Okavaks, Varilriks, Varivaks
For emergency prophylaxis use any vaccine: 1 dose (0.5 ml) optimally in the first 72 hours, permissible in the first 96 hours after contact with the infected.
Vaccines form a strong immunity for many years and are used for primary prevention.
To prevent the development of chickenpox complications, it is necessary to consult a doctor in a timely manner and follow all his recommendations. Considering that the nature of the course of infection depends on the state of general body resistance, you should lead a healthy lifestyle and give up bad habits.
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Chickenpox incubation period in adults
If you were in direct contact with a person who happened to be sick with chickenpox after a while, then do not rush to panic, because the person becomes infectious 2-3 days before the rash appears on the body, and they develop approximately 10-23 days after infection.
It is known that almost every infectious disease has a latent flow time, when the infection has already infiltrated the body, has begun to adapt and develop, but the clinical manifestations of the disease are still absent. This period is called the incubation period and lasts until the first symptoms of the disease appear. Typically, the incubation period of chickenpox in adults consists of three stages:
1. Approximate beginning of the incubation period. It is considered from the moment of the first contact with a sick person, if the disease has already manifested itself in acutely current form. Usually one or two days are added to this date, which is necessary for the chickenpox virus to take root in the human body.
2. Development of the incubation period. The causative agent at this time begins to multiply actively, its concentration in the body increases. First of all, the mucous membrane of the upper respiratory tract is affected, the virus adapts there and transfers to neighboring cells, that is, the infection grows along the periphery.
3. End of incubation period. When the amount of the pathogen reaches the required volume, it enters the bloodstream and is carried by the bloodstream throughout the body. At this stage, the virus enters the skin cells - the epidermis, causing the appearance of the first symptom characteristic of chickenpox - a skin rash. The human immune system begins to actively resist infection and produce antibodies to the disease. As a result of this virus counteraction with antibodies, the patient's body temperature rises sharply, chills and general malaise appear.
The duration of the incubation period is on average from one to three weeks (it can not last less than one week, but can last more than three weeks). The difference in the duration of the incubation period depends on a number of reasons and the volume of the chickenpox virus in the body at the time of infection, the degree of pathogenicity of this type of virus, and the state of the immune system play a huge role. Of great importance is the place of human infection, because there are usually much more pathogens present in the room than in the open air.
As shown by clinical studies, it is not necessary that the incubation period will proceed in three stages, the clinical manifestations of the disease can begin in any of them. It is believed that seven days after contact with a sick chickenpox, a person can serve as a source of infection, because it is not known exactly how quickly the virus multiplies in the body.
Chickenpox has one characteristic feature that makes it very dangerous for others: after the prescribed three weeks of the incubation period and in the absence of obvious clinical manifestations of the disease, a person can begin to lead a normal life, thinking that the danger of infection for others has passed.
There are cases of disease progression and in a secretive form, when a small amount of rash may appear on the face and body of the patient, insufficient to suspect one of the symptoms of chickenpox. However, such a patient is capable of infecting others at the same time.
The end of the incubation period is considered to be the onset of the first signs of the disease, most often the body temperature rises and a rash appears, which is a direct indication for isolating the patient.
Expert Editor: Pavel Alexandrovich Mochalov | D.M.N. general practitioner
Education: Moscow Medical Institute. I. M. Sechenov, specialty - “Medicine” in 1991, in 1993 “Occupational diseases”, in 1996 “Therapy”.
Why are adults harder to take chickenpox
Children suffering from chickenpox are still protected by maternal immunity, and if a woman has previously suffered this disease, it proceeds in a mild form in a child. An adult has developed its own immunity, the body has not previously encountered a virus, which is why the symptoms of the disease are more pronounced, and the person suffers more severely from the disease.
Chickenpox all proceeds in 4 stages:
- Period of rash.
- The period of formation of crusts.
If a child has it in a mild form, then for adults this disease can be a harbinger of serious complications, especially in people with weakened immunity.
The symptoms in an adult are similar to the manifestations of chicken pox in children, but the risk of developing complications is much higher. After 20 years, the incubation period of the disease lasts longer, more than 2 weeks, and symptoms can appear only for 3 weeks after contact with the patient, then chickenpox rash appears.
On the body of an adult, unprotected by maternal immunity, more active rashes appear, itchy and quickly spread. However, there is a syndrome of intoxication.
What are the typical manifestations of chickenpox in an adult:
- weakness and body aches,
- general malaise,
- increase in body temperature up to 40 degrees
- constant thirst
- increase in cervical and zaushny lymph nodes,
- rash all over, including mucous membranes.
With chickenpox in adults, the rash also has characteristic differences. The bubbles appear on the skin and mucous membranes, starting with the abdomen and legs, then spread to the upper body and head. At first, the rash element is a small red bump, then it becomes a bubble with liquid.
With a certain periodicity, the bubbles burst, turn into vesicles covered with a crust.It can be rejected for several weeks, that is, until the time of recovery.
Rash with chickenpox, photo №2 - light form
The rash is severely itchy, and a person can comb it. This increases the risk of skin infection and the spread of the herpes virus throughout the body. Recovery is the moment when the last crust of the vesicle disappears.
What is dangerous for chickenpox adults
The most common complication of chickenpox is scarring on the body. For health, they are not dangerous, but affect the appearance of a person, provoking psychological discomfort. Their education is due to the fact that the patient combs the rash, causing infection in the wound. Infection becomes a factor in the formation of sores, which leave scars behind.
Among the possible effects of chickenpox are:
- Impairment of vision, optic neuritis - a virus with non-compliance with personal hygiene can spread to the cornea, and then the rash can be observed even on the white of the eye, and bubbles appear above it, then scars, which affects the vision.
- Damage to the brain - with an unfavorable course, there is a risk of damage to the nerve cells and lining of the brain, which will manifest as headache, cramps, loss of consciousness, paralysis of the facial nerves.
- Laryngotracheitis - manifested soreness in the throat, tearful cough, which is explained by the appearance of a rash on the mucous membrane of the upper respiratory tract.
- Myocarditis is an inflammation of the heart muscle, a serious complication that requires the immediate help of a specialist.
- Stomatitis - on the oral mucosa also bubbles form, bursting, they lead to the formation of ulcers with severe pain and inflammation of the mucous membranes.
There are complications more often in adults with a weakened immune system. In this case, the older the person, the more difficult it will be to undergo treatment. As soon as we managed to notice the signs of complications of chickenpox in adults, you should immediately consult with your doctor.
A specific complication of varicella in adults will be varicella pneumonia. It occurs in 20% of patients, mainly with a weakened immune system. Its symptoms can be observed 3-5 days after the rash appears.
Manifestation of chickenpox is manifested by fever, chest pain, cough, shortness of breath. The diagnosis is confirmed by radiography and virologic examination.
With a severe form of the disease, the patient begins to develop blood with sputum, it becomes difficult to breathe, and severe headaches appear. Complementary symptomatic complex nausea, vomiting, fever. Without treatment, hemoptysis and severe dyspnea can be fatal factors for several days. The cause of death in this case will be respiratory failure.
The risk of developing chickenpox encephalitis in adulthood increases one week after the onset of the rash. Against the background of active rashes, nausea, vomiting, worsening intoxication and headaches.
Neurological and meningeal symptoms are characteristic of varicella encephalitis. The patient is worried about stupidity and confusion.
What else is interesting about this disease is the likelihood of late consequences. Another complication of chickenpox in adults is shingles. The virus is remembered by the body, forms a persistent lifelong immunity. However, under the influence of adverse factors, it manifests shingles.
If chickenpox happens in life only once, then herpes zoster can recur. This disease is accompanied by terrible pain, because the skin is damaged along the nerve trunks. In most patients, the characteristic elements of the rash appear on the body.
The disease is usually manifested by itching, fever, severe weakness, malaise. The pain has a neurological character. This disease lasts about a month (in some cases up to 10 days). Pain can also persist after recovery.
When this complication occurs, there are several problems with chickenpox:
- reduce the severity of pain,
- reduce the likelihood of postherpetic neuralgia,
- accelerate the onset of recovery,
- prevent complications.
Drug treatment is not always required. Antiviral therapy is more often prescribed for people with immunodeficiency and after 50 years. The effectiveness of this treatment for young people is not proven. In severe cases, hospitalization is required. The indications will be eye and brain damage.
Consequences of chickenpox in women
Vulvitis is an inflammation of the female external genital organs. This disease can occur if the rash begins to spread to the mucous membranes. With this complication of chickenpox, the woman begins to have heavy discharge, the labia swell, painful sensations appear.
This is a consequence of chickenpox in women is dangerous because the infection can spread to the internal organs. With this complication, you must visit a gynecologist, otherwise there is a risk of infertility.
Pregnant women are also at risk for the disease. Immunity during this period is weak, and diseases can have serious consequences, both for the future mother and for the fetus. An important role is played by the prevention of chickenpox during pregnancy planning and throughout its life.
Consequences of chickenpox in men
Balanoposthitis - inflammation of the glans penis. This is a consequence of chickenpox in an adult male when the rash began to spread to the external genitals. In this disease, the patient suffers from severe itching, inflammation and swelling of the tissues.
With this complication of chickenpox, a man must undergo treatment by contacting a urologist. Without special therapy, phimosis may occur, in which surgical intervention is indicated.
How to avoid complications
The first important measure to prevent complications of chickenpox in an adult is the timely start of antiviral therapy. At the first symptoms of the disease, you need to call a doctor to confirm the diagnosis and prescribe treatment.
Rules of conduct for chickenpox to prevent the consequences:
- bed rest - the patient is isolated from others for the entire period of the disease, in addition, he must be warm, avoid drafts, temperature drops,
- drink plenty of water - you need to drink plenty of clean water, juices, teas, fruit drinks, to reduce the manifestations of intoxication of the body,
- to carry out hygiene procedures - you need to take a shower every day without the use of a washcloth.
In the period of active appearance of lesions in any case, you can not use a washcloth and hard towels. One should try to avoid any damage to the skin. It is also forbidden to self-peel.
There are cases when adults, trying to hide the disease to continue work, almost completely stripped all the bubbles with a hard washcloth and towel. This is extremely dangerous, as extensive skin contamination can occur with dire consequences.
Recovery, if the disease is uneventful, occurs approximately 2 weeks after the onset of the rash. In severe form of chickenpox, this period can be delayed for a month or more, then hospital treatment is indicated.
Chickenpox in adults - symptoms and treatment
Do not be afraid of chickenpox at any age, because knowing the features of its treatment and prevention of complications, you can avoid unpleasant consequences and stay with clean skin without scars. If the disease is severe, it is important to consult a doctor who will prescribe a special treatment. What exactly you do not need to do is to ignore the disease.
Causes of chickenpox in adults
Chickenpox pathogen - human herpes virus type 3, or Varicella Zoster. A virus particle is a DNA molecule surrounded by a protective membrane of lipids.
The virus can exist exclusively in the human body. In the environment, it dies within 15 minutes. This is facilitated by drying, heating, freezing. The causative agent of chickenpox is not transmitted through things and third parties. Animals do not have chickenpox and cannot be carriers of infection.
The main characteristics of chickenpox virus, allowing to hit a large number of people - volatility and susceptibility. Virus particles with air flow scatter and penetrate into the next room, apartment and from one floor to another. And the high susceptibility of people to the chickenpox virus means that when they come in contact with a patient, almost all people who have not been ill before become infected. In a family where one person fell ill, the risk of illness of other households is 80-90%. Moreover, those who became infected later, the disease is more severe and with a large number of rashes.
Source of infection and the main reservoir of infection is a person with chickenpox. There is a risk of infection from a person with shingles.
Ways of infection - airborne and transplacental, when the virus is transmitted from the mother to the fetus through the placenta.
Incubation period - 10-21 days, more often 14-17. During this time, the virus multiplies on the mucous membranes of the nasopharynx and spreads through the lymphatic system.
Chickenpox Immunity produced after infection. It is believed that post-infectious immunity provides lifelong protection against infection. However, some people record repeated cases of chicken pox, which is associated with a weakening of the immune defense.
What happens in the body of the patient?
1. The virus multiplies on the mucous membranes of the upper respiratory tract.
2. Its quantity is rapidly increasing. Through the tonsils, the virus enters the lymphatic system, inhibiting its work and reducing the activity of T-lymphocytes.
3. The virus enters the bloodstream at the end of the incubation period. Viral particles and their metabolic products present in the blood cause fever, weakness and other signs of intoxication.
4. The virus penetrates the nerve ganglia - the nucleus of the spinal nerves, causing lysis (destruction) of nerve cells. In the future, the virus persists for life in the nerve ganglia. With the weakening of immunity, it is activated and spread along the nerve, provoking the development of shingles.
5. The virus is deposited in the cells of the epidermis. It causes the appearance of vacuoles - intracellular elements resembling vesicles. The vacuoles of neighboring cells merge with each other, forming cavities that are the basis of papules. These papules are filled with fluid, which contains a large number of viral particles and protein molecules. The contents of the papules are a good breeding ground for bacteria, so elements of the rash can fester. In this case, a pustule is formed at the site of the papule (vial with purulent contents).
6. The bubble bursts, its contents are poured onto the skin. In place of the bubble a crust forms, under which the healing of the epidermis occurs.
7. Starting from the first days of the disease, the immune system recognizes the pathogen and begins to produce immunoglobulins that bind toxins and stimulate phagocytosis (absorption) of viral particles. In the future, anti-windout antibodies remain in the blood of a person who has been ill for life. They provide protection against recurrent chickenpox disease.
The symptoms of chickenpox in adults
The symptoms of chickenpox in adults are a deterioration of the general condition, fever and maculopapular rash, accompanied by itching. Signs of the disease in adults appear much brighter, and the disease is more severe than in children.
In the development of the disease there are several periods:
- Incubation period - The virus multiplies in the cells of the nasal mucosa. No symptoms of the disease.
- Prodromal period - the release of the virus in the blood. Symptoms: fever, deterioration of general condition, weakness, loss of appetite.
- Period of rash - The active phase of the disease, when the virus is localized in the epidermis. It is characterized by the appearance of rash and itching, which is accompanied by an increase in temperature.
- Period of formation of crusts - elements of rash dry up. In the body, anti-wind antibodies are actively produced, which provide for virus binding and recovery.
Symptoms of chickenpox in adults:
|Pruritus||Changes in epithelial cells irritate the sensitive nerve endings that are found in the skin. From them, the nerve impulse enters the central nervous system and is perceived by the brain as an itch.||Itching occurs simultaneously with spots on the skin. It bothers the sick until the formation of crusts.|
Itching increases at night when there are fewer distractions.
|Rash on the oral mucosa||In the cells of the mucous membranes the same processes occur as in the skin.||Rash appear simultaneously with a rash on the skin. On the mucous membrane of the gums, palatine arches and soft palate red spots of 3-5 mm form. Over time, spots form nodules, and then bubbles. A few hours later, ulcers (aphthae), covered with a white and yellow patina, appear in their place. Ulcers cause great pain.|
Similar eruptions appear on the mucous membrane of the vagina in women. They cause severe itching and discomfort.
Classification of chickenpox in adults. Forms and stages
There are several classifications of chickenpox.
1. By severity
- Mild form in 7-10% of patients. The temperature rises to 38 degrees. Overall condition is satisfactory. The amount of rash is moderate.
- Moderate form in 80%. Temperature 38-39 degrees. Severe intoxication - weakness, nausea, vomiting, aching muscles and joints. Rash abundant, accompanied by severe itching.
- Heavy form in 10%. Temperature 39-40 degrees. The general condition is severe, severe weakness, repeated vomiting, headache. Rash can cover the entire surface of the skin. Various complications develop. In severe form, there are several variants of the course:
- Hemorrhagic form. It is rarely seen in patients with weakened immunity who have previously experienced hemorrhagic diseases - lesions of the blood vessels: hemorrhagic diathesis, vasculitis, thrombocytopathy, bleeding disorders. Accompanied by the development of hemorrhagic rash (minor hemorrhages), hematomas, bruises, bleeding gums, intestinal bleeding.
- Bullous form. Simultaneously with typical vesicles, large flabby blisters appear on the skin - bullae. They are filled with turbid contents and have a folded surface. In place of their resolution remain long-healing wounds.
- Gangrenous form. It is extremely rare in severely debilitated patients, with non-compliance with the rules of hygiene and poor care. Develops with infection of papules and the accession of a secondary infection. A black border is formed around the papules, consisting of necrotic, dead tissue. The disease is accompanied by intense fever and intoxication.
2. According to the type of the disease
- The typical form is manifested by intoxication, fever, characteristic rash.
- Atypical form has several options for the flow.
- The rudimentary form is a temperature rise of up to 37.5, single elements of the rash, which may have the form of spots or nodules. The disease often goes unnoticed.
- The atypical ones include gangrenous, bullous and hemorrhagic forms described above.
- The generalized (visceral) form is associated with a massive lesion of internal organs. It occurs in people with weakened immunity when the virus multiplies in the cells of internal organs. Manifested by abdominal pain and lower back, severe damage to the liver, kidneys and nervous system, lower blood pressure and pulse rate.
Examination by a doctor. As a rule, diagnosis of chickenpox does not cause difficulties for a specialist. A doctor may suspect chickenpox in an adult on the following grounds:
- A characteristic rash that appeared on the background of increased temperature and deterioration of the general condition,
- Periodic drops, which are accompanied by a rise in temperature,
- False polymorphism rash. On a limited area of the skin at the same time there are various elements of the rash - spots, nodules and blisters,
- Localization of the rash on any part of the body, except the palms and soles,
- Rash on the mucous membranes of the mouth, genitals and conjunctiva,
- There has been contact with sick chickenpox.
After examining the skin and mucous membranes, the doctor listens to the condition of the bronchi and lungs, feels the stomach, determines the size of the liver. Examination allows timely detection of complications. In most cases, other studies are not necessary.
1.General blood analysis. The result may be within the normal range or indicate inflammation - increased ESR. Possible increase in the level of monocytes and the appearance of plasma cells.
2.OverallAnalysis of urine. Urine unchanged. The appearance of protein, red blood cells and white blood cells indicate a complication of the kidneys.
- The contents of the vesicles are stained by silver plating and examined under a microscope.
- Identification of antigen by immunofluorescence. The material for the study - the contents of the bubbles and ulcers, crusts, mucus from the aft in the mouth.
5.Serological method - detection in the blood of immunoglobulins M and G - antibodies to varcelcell-zoster virus, the pathogen of chickenpox. Antibody titer is examined 7-10 days after the onset of the disease. Repeated research is carried out in 2-3 weeks. If the amount of antibodies has increased 4 or more times, this confirms the diagnosis of chicken pox.
In controversial cases, serological and viroscopic methods can distinguish chickenpox from other diseases that have similar symptoms: herpes zoster, infections caused by the Koksaki virus, vesicular rickettsiosis, polymorphic exudative erythema.
Treatment of chickenpox in adults at home is allowed. At the same time, it is important to strictly adhere to bed rest, personal hygiene rules and doctor's recommendations.
Indications for hospitalization for chickenpox:
- development of complications
- severe disease
- inability to isolate the patient.
Chickenpox is accompanied by high fever and poisoning by viral toxins. Patients increase energy costs and protein breakdown, inhibits the function of the digestive glands and gastrointestinal organs. The diet for chickenpox takes these changes into account and provides a sufficient supply of energy substances, water and vitamins.
Nutrition patients should be varied in composition. Food is given in a wiped and semi-liquid form, especially if the mucous membranes of the mouth and pharynx are affected.
For chickenpox recommended:
- weak meat and fish broths,
- steamed patties and meatballs,
- rubbed soups mucous,
- mashed potatoes or caviar from vegetables
- kefir, yogurt and other dairy products,
- cottage cheese with sour cream, cottage cheese souffle,
- beaten egg or steamed omelet
- not hard berries and fruits, mousses, mashed potatoes and juices from them,
- juices with pulp, weak tea with lemon or milk, rosehip broth.
After the oral mucosa is restored and the temperature returns to normal, you can return to your normal diet.
Before recovery, it is necessary to observe the drinking regime, especially for patients taking acyclovir and other antiviral drugs. Water can be drunk in pure form or in the form of compote from dried fruits and tea.
Should you vaccinate a chicken pox for adults?
- People who are preparing for an organ transplant.
- Prone to severe varicella - hemorrhagic diseases, decreased immunity, age over 50 years.
- Patients at high risk of the disease. These include:
- leukemia patients
- receiving immunosuppressive therapy (including glucocorticosteroids),
- patients with malignant tumors,
- people with severe chronic pathologies - bronchial asthma, collagenosis, autoimmune diseases, chronic renal failure.
- People who are in close contact with patients at high risk for the disease are relatives, family members.
- Medical personnel, especially those working in infectious departments.
- Employees of preschool educational institutions.
Vaccination with live vaccines is contraindicated:
- oncology patient
- people suffering from AIDS and primary immunodeficiency states
- receiving immunosuppressive therapy
- with hypersensitivity to vaccine components and neomycin.
For vaccinations against chickenpox adults use a specific immunoglobulin and a live vaccine.
Active immunization against chickenpox - introduction of a vaccine based on live attenuated virus Varicella Zoster. The pathogen, treated in a special way, causes a mild, asymptomatic form of chickenpox. After this, the production of specific immunoglobulins occurs, which remain in the blood, providing long-lasting immunity.
- Okavaks - vaccine against chickenpox Japanese production. Enter subcutaneously once in the deltoid muscle. The drug is allowed to children from 12 months of age and adults. Suitable for emergency prophylaxis in the first 72 hours after contact with the patient.
- Varilriks - vaccine Belgian production. The drug is injected subcutaneously into the deltoid muscle. Adults inject the vaccine 2 times: the first dose on the appointed day, and the second after 4-6 weeks. Allowed to adults and children from 9 months of age. Suitable for emergency prophylaxis for the first 96 hours after contact.
Passive immunization against chickenpox - the introduction of donor antibodies against the pathogen of chickenpox. They are obtained from the blood plasma of the convalescent (who had been ill with chickenpox). Antibodies (IgG) neutralize a virus that is already present in the body. The drug does not contain the virus itself and does not provide long-lasting immunity, unlike live vaccines.
- Zostevir is a preparation containing immunoglobulin against varicella-zoster virus. Immunoglobulin against the virus Varicella Zoster can be used for treatment and emergency prophylaxis after contact with the patient. Allowed for use from the first day of life, as well as pregnant women and nursing mothers.
To determine the presence of immunity to varicella helps blood test for the detection of antibodies to the virus Varcella-Zoster. The result will have to wait 6 days. A positive test result suggests that a person already has immunity against chickenpox, and he does not need to be vaccinated.
Is repeated chickenpox possible in adults?
Repeated chickenpox in adults is possible, especially in people with weakened immune systems. As a rule, recurrent disease occurs in a milder form.
Repeated chickenpox occurs in some categories:
- In people with a weakened immune system. This condition can occur with prolonged use of antibiotics, corticosteroids, immunosuppressants,
- Suffered heavy emotional turmoil,
- In people with diseases of the digestive system and deep eating disorders.
Sometimes repeated chickenpox in adults is called shingles. This disease is caused by a virus that remains in the spinal nodes after the first infection with chickenpox.
Complicated or abnormal forms of chickenpox
The most dangerous forms of chickenpox, appearing for the same reasons as complications, are:
- Gangrenous form of chickenpox. It occurs due to penetration into the wound when combing the rash of pathogenic bacteria, which subsequently enter the bloodstream. With this form of complicated varicella, there is a transformation of lesions (the bubbles become cloudy, due to the ongoing purulent processes in the skin epithelium and increase slightly in size), the body temperature rises to 40 degrees and above. Perhaps the appearance of delusions, impaired coordination of movements, involuntary twitching of limbs or certain muscle groups, nausea, vomiting. The consequences of this form of illness are necrosis of the skin tissues, at worst gangrene and loss of limbs. In the absence of proper medication, sepsis can develop. The gangrenous form of the chickenpox is deadly,
- Chickenpox hemorrhagic form, photo. It occurs due to the complete defeat of the virus of the whole organism. At the same time, there is a change in the varicella rash (there is an admixture of blood in the fluid contained in the vesicles, the rash itself slightly increases in size), skin hemorrhages may appear, nose bleeds, hemorrhages in the sclera, urine and stools with blood, etc. The temperature reaches 40 degrees and higher, acute headaches, vomiting, a violation of the central nervous system, involuntary movements, delusions and so on. This form of illness is fatal,
Note that the appearance of the above presented forms of chicken pox is a rarity today.
Complications from Chicken Pox
There is another possible complication that may appear decades later. It is shingles or herpes zoster. If you look, this is a separate disease, but some medical sources think differently.
The fact is that after suffering a disease, even in childhood and in mild form, there is a 15% chance that you will again meet with the manifestation of the varicella-zoster virus, as it does not completely eliminate, but remains with the person for life, hiding in the cells of the nervous system. For the time being, the virus is not active and does not interfere with living, but by reducing the activity of the immune system, the pathogen of chickenpox will show itself again, but already in the form of herpes zoster. The disease is characterized by unilateral herpes-shaped rashes on the body, accompanied by itching and pain. Itching and rash disappear after 2-4 weeks even without therapy, but the pain may persist for several months or even several years. This is called "postherpetic neuralgia."
In this article we presented an incomplete list of possible complications of the infection.
Are there any cases of chickenpox with complications? There are, but thanks to modern methods of treatment and prevention of infectious diseases, it is extremely rare.
When do complications appear? With improper and late treatment.
Is chickenpox possible without temperature?
In rare cases, chickenpox is possible without temperature. This is the so-called erased or abortive form.
Symptoms of the erased form:
- Slight malaise - weakness, loss of appetite,
- Single elements of a rash are a few red spots and nodules that usually do not turn into bubbles.
Causes of chickenpox with no temperature:
- Weakened immunity. Viruses and their decay products do not induce an adequate immune response.
- Chickenpox transferred at an early age (up to a year). In this case, chickenpox in an adult is considered to be repeated. In his blood there is a small amount of antibodies that do not allow the virus to actively multiply and cause fever.
- Receiving drugs that reduce the temperature. At the first symptoms of deterioration, many self-medicate and take drugs containing paracetamol. Thus, they knock down the temperature, and the picture of the disease is distorted.
How long does chickenpox last for adults?
The duration of uncomplicated chickenpox in adults is 9 days from the onset of the first signs. After that, the doctor can close the sick-list.
In practice, in 90% of patients the disease lasts 10-14 days:
- prodromal period (no rash) - 2-3 days,
- the period of appearance of new lesions is 3-4 days,
- the period of formation of crusts is 5 days (since the appearance of the last rash).
Only after the last vesicle has become covered with a crust, the patient is considered not infectious. The skin is completely cleared of crusts in 2-4 weeks.
Are there scars on the skin?
With an uncomplicated course of the disease, there are no scars after chickenpox. The varicella-zoster virus affects only the upper layers of the epidermis, and the germ layer responsible for skin repair remains intact.
Scars appear when bacteria enter the vesicle and purulent inflammation develops. In this case, the melting of the deep layers of the skin. After the crust disappears under it, a groove with jagged edges — Oppin — is found. In the future, the "fossa" remains, but is aligned in color with the surrounding skin.
How to prevent the appearance of scars after chickenpox?
- Compliance with the rules of hygiene - regular change of linen, shower,
- Treatment rash antiseptics - Zelenko, fukortsinom,
- The appointment of broad-spectrum antibiotics when the first pustules appear.
What if there are scars after chickenpox?
- Ointments and gels for the treatment of scars. 2-3 times a day, rub a small amount of gel into the scar. When old scars gel is applied under the bandage for the night. The course of treatment may take from 1 month to a year. For treatment are used:
- The introduction of collagen under the skin. The substance fills the skin defect and stimulates the formation of connective fibers.
- Chemicalpeelingusing phenol. Under the influence of aggressive chemicals horny layer of the epidermis and dermis is removed. After the restoration of the epidermis (takes up to 2 weeks), the skin becomes smooth.
- Laser skin resurfacing. The focused laser beam penetrates the surface layers of the dermis and heats them, evaporating water. After regeneration of skin cells, its surface is flattened. Warning: treatment with a carbon dioxide laser can cause a hypertrophic keloid scar, towering over the skin. Therefore, an erbium or carbon dioxide laser is used.
- Microdermabrasion - mechanical polishing of the skin with solid particles (diamond). As a result of microtraumas, collagen production is activated. The procedure allows to even out the skin relief and make the scars less noticeable.