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Chickenpox is highly contagious viral disease caused by varicella zoster virus. It is characterised by itchy, crusty blisters, fever and malaise and in severe cases can lead to pneumonia. The lesions scab later in the course of disease.

Medications:

  • Lotion Lactocalamine (contains Zinc Oxide) apply over itchy areas as needed.
  • Tab. Atarax 25 (Hydroxyzine 25 mg) 1 tablet 4 times a day. In children under 6 years give 50 mg per day in divided doses and over 6 years give 50 –100 mg per day in divided doses.
  • Ointment Neosporin (Bacitracin, Neomycin, Polymyxin B) for local application 2-3 times a day to reduce the bacterial overgrowth.
  • Tab. Dolo 650 (Paracetamol 650 mg) 1 tablet 3-4 times a day for 3-5 days.
  • Tab. Axovir 800  (Acyclovir 800 mg) 1 tablet 4 times a day for 7 days.
  • Ointment Cloviderm 5% (topical Acyclovir 5%) for local application.
  • Tab. Wymox 500 (Amoxicillin 500 mg) 1 tablet thrice a day for 7 days (in case of secondary infection).

General advice:

  • Ensure adequate hydration and good nutrition.
  • Nails should be trimmed short to avoid scratching and to avoid secondary infection of the lesions.
  • As this is highly contagious air borne viral illness, avoid contact with pregnant and immunocompromised people until  scabs are formed.

Investigations:

Chickenpox is diagnosed based on clinical presentations. However following test could be helpful when diagnosis is in doubt and in pregnancy and immunocompromised conditions.

  • Varicella PCR
  • Varicella tissue culture
  • Vesicular fluid test for Tzanc smear
  • Renal function tests – for patients on Acyclovir. Please adjust dose of Acyclovir in case of renal dysfunction.

Referral:

Refer to the infectious disease consultant if diagnosis is unclear. Hospitalization and referral to physician may be needed in seriously ill patients.