Chickenpox in children: photos, symptoms and treatment
- Causes of chickenpox
- Brief description of the causative agent of chickenpox
- Prevalence of chickenpox
- When is a person contagious?
- How does chickenpox develop?
- Chickenpox in children: symptoms
- Typical and atypical signs of chickenpox
- What are the possible complications?
- Diagnosis of chickenpox in children
- Treatment of chickenpox in children
- How to prevent chickenpox?
Chicken pox is an acute infectious disease, mainly of children's age. Annually, this pathology affects several million babies, who subsequently develop a permanent immunity to this disease.
How does chickenpox look like in children, how long does the incubation period last, what are the symptoms and methods of chickenpox treatment you will learn from this article.
Causes of chickenpox
The correct scientific name for "chickenpox" is chicken pox. This is due to the fact that the clinic of this pathology somewhat resembles a smallpox, which today is completely eliminated in the world.
The direct causative agent of the disease is the varicella-zoster virus (scientific name Varicella zoster). This pathogenic agent is found in the liquid of the blisters on the skin from 3-4 days after the appearance of the first signs of the disease. A week after the debut of the disease, it is no longer possible to detect a varicella-zoster virus in pathological elements on the skin. If, under the influence of therapy, the virus has not been completely eliminated from the body, it can persist and multiply in the ganglia of the central nervous system, causing a person to develop such a disease as herpes zoster.
Infection occurs by inhalation with inhalation of infected air. The source of dissemination of varicella is a sick person or a healthy carrier of the causative agent of the disease. Casual is rarely possible vertical (transplacental) transmission of the disease from mother to child, who is in her womb.
Brief description of the causative agent of chickenpox
The virus of chickenpox belongs to the herpes group of viruses. Outside the body, this pathogenic agent dies within 5-7 minutes. It also has a harmful effect on sunlight and the effect of high temperatures.
Prevalence of chickenpox
The most susceptible to chickenpox are children, who are of the younger preschool age (6-7 years). Especially quickly the disease spreads among toddlers in organized collectives, such as kindergartens, schools and preschool groups.
Interesting is the fact that there are no people who are not susceptible to chicken pox. This means that any person who has never had a history of chickenpox before, can come into contact with a sick or a virus carrier with 100% probability.
When is a person contagious?
A high probability of infection of surrounding people exists up to 5 days after the disappearance of the last element of skin rash. Also, people can become infected when the patient is in the incubation period (the day before the signs of the disease appear). Epidemiologists are advised to isolate patients on day 21 after the diagnosis of varicella.
How does chickenpox develop?
After the virus has entered the epithelium of the mucous membrane of the respiratory tract, its active reproduction begins. Soon it penetrates into the bloodstream and affects the skin cells, especially its epithelial layer. There a complex of the following pathological reactions arises:
- Cell death with the formation of blisters filled with serous fluid;
- Local inflammatory response, which is accompanied by the release of mediators of inflammation, edema and vasodilation of the microcirculatory bed.
Naturally, a virus that is contained in a high concentration in the blood, there is an immune response, which is accompanied by the release of biologically active substances - interleukins. They penetrate the nervous system and cause feverish reactions from the body.
Symptoms of chickenpox in children
During the disease, the following periods are singled out, each of which is characterized by its specific symptomatology.
- . The incubation period of chickenpox . This is the time interval that begins when the chickenpox virus enters the baby's body. It ends at an average of 12-14 days (minimum - after 5, maximum - after 21 days). The main sign of its end is the appearance of the first visible symptoms of the disease.
- . The prodromal period . As a rule, with chickenpox its duration does not exceed 1-2 days. It is characterized by the appearance in the patient of general nonspecific symptoms of intoxication (fever, chills, increased sweating, fatigue, depression of mood). The child often refuses to eat, can become whimsical. On a walk quickly gets tired and begs for home. In addition, the baby significantly reduces appetite; As a result of the toxic effect of the virus on the nervous system, vomiting may occur, which does not bring relief. Some patients may not have a prodromal period.
- . Appearance of rashes on the skin . In most cases, it is accompanied by a maximum increase in body temperature. Important is the fact that the pathological elements on the skin appear as if by waves, that is, after the first wave of eruptions subsides, the second wave.
As a rule, the first morphological elements on the skin appear in the region of the head (its hairy part), as well as on the back. In the future, rashes can be detected not only on any part of the skin, but also on the mucous membranes of the mouth or eyes. The skin of the feet, and also of the palms, is never affected by the pathological process.
What does the rash on the body look like with chicken pox?
It should be borne in mind that a characteristic rash on the skin in the form of vesicles never occurs in the first days of the disease. The rash with chicken pox passes through the following metamorphosis:
- . Stain . Its appearance is due to the local expansion of the vessels of the microcirculatory bed in the place on the skin where the pathogen has been introduced. The dimensions of these spots do not exceed 5-6 mm, they do not rise above the level of the rest of the skin and have distinct edges (see photo);
- . A vial . Appears on the spot where there was a stain 5-6 hours after the appearance of the first morphological element on the skin. The contents of the vesicle are serous (clear) liquid, where virus cultures are found in high concentrations (see photo). If suppuration occurs, then deeper layers of the skin may be affected and then ugly scars form;
- . Crust . After some time, the bubble cover bursts, its contents pour out, and on the place where the primary morphological element was located, a crust is formed (see photo).
Typical and atypical signs of chickenpox
There are several variants of manifestation of the disease, which, depending on the similarity of external manifestations with known clinical signs, can be typical and atypical.
In a typical variant of chickenpox, the general condition of the child is usually not disturbed. Occasionally, the temperature may rise, but it rarely oversteps the febrile threshold (38 ° C). On the skin there are a lot of morphological elements that are at different stages of their development. A typical rash on the mucous membranes (it is called enanthemoma) is found in 7 children out of 10. Unlike adults, complications in children suffering from chickenpox are very rare.
The atypical variant combines several clinical manifestations of chicken pox: gangrenous, bullous, rudimentary, hemorrhagic and generalized.
Gangrenous form of chickenpox is characterized by a progressive lesion of deep layers of the skin with a gradual dying out (necrosis). The process of necrosis begins a few days after the appearance of the first rashes. Its characteristic feature is the appearance of thin dark purple rims around the skin blisters. The contents of the latter (in contrast to the classical version of chicken pox) is not a transparent liquid, but a dark red sap. After the morphological vesicle burst, a coarse crust (a scab) is formed in its place, under which there is a deep ulcerous surface, which is extremely difficult to heal. The clinic of this disease is dominated by the phenomena of severe general intoxication and lesions of the nervous system. The lethality with this variant of chickenpox continues to remain at a very high level even despite the use of modern standards of treatment of patients. Gangrenous type of varicella, fortunately, is extremely rare, mainly in children with severe immunodeficiency.
Bullous form of chickenpox is characterized by the appearance on the skin of huge bubbles, which are filled with a turbid yellowish liquid. Tires of these formations are flabby, and when they break, then on their bottom are found long-lasting non-healing ulcers. Occasionally a few large bubbles can merge into one giant, after the rupture of its walls on the skin remains a deep wound. Its bottom is often covered with fibrin.
The generalized (general) form is characterized by the defeat of all internal organs. If the delay or wrong tactics of treatment, the patient may die. In most cases, people with severe immunity defects become sick with this variant of chicken pox. For example, when taking steroid hormones or antitumor drugs.
Unlike the generalized, rudimentary form refers to the easiest manifestations of chicken pox. Eruptions, as a rule, are extremely meager, often they do not reach the stage of bubbles or crusts. Skin rash often remains at the stage of such a primary morphological element as a stain.
The hemorrhagic variant of the disease is also quite severe for the patient. As its name suggests, the contents of the blisters are not serous (inflammatory) fluid, but blood. Many patients develop blood clotting disorders that are manifested by bleeding from the nose or gingival pockets. The crusts formed on the place of the bubbles have a dark red color, after their falling out there are deep scars. As a rule, the hemorrhagic form of the disease occurs in patients with hematopoietic pathology (eg, thrombocytopenia).
What are the possible complications?
Fortunately, most children recover safely from chicken pox. However, in some categories of patients, the disease can have adverse outcomes, such as:
- Pustular lesions of the skin : phlegmon, abscesses or furuncles. They are the result of penetration into the liquid inside the vial of pathological microorganisms, which, upon contact with neutrophils, can form pus;
- Encephalitis . This pathology is manifested by severe damage to the central nervous system, manifesting seizures. This is due to the high tropism of the virus to the nervous tissue. In most cases, this complication is found in patients on the 7-12 day of the disease. Relatively rare there is a persistent violation of higher nervous activity in the form of idiocy;
- Myocarditis - inflammation of the heart muscle. It is manifested by deafness of cardiac tones, pains in the region of the heart, as well as changes in the cardiogram;
- Pneumonia . The most commonly diagnosed in adults. The peculiarity of chickenpox pneumonia is the extreme scarcity of clinical symptoms. The diagnosis can be made only radiologically, while in the picture, small inflammatory foci are found practically throughout the entire length of the lung tissue;
- Pathology of the structures of the eyeball (keratitis) ;
- Hepatitis ;
- Nephritis - an inflammatory disease of the kidneys, which most often occurs on the 10-12th day of the disease. In most cases, this pathology passes on its own and does not require any specific therapy.
Diagnosis of chickenpox in children
It is not difficult to diagnose varicella if the disease is in the phase of detailed clinical manifestations. If it is a question of atypical variants of the disease, then it is necessary to perform the following program of examinations:
- clinical blood test;
- Biochemical examination of venous blood samples with mandatory determination of the quality of liver, kidney and pancreas functioning;
- Titer of antibodies to the varicella-zoster virus.
Treatment of chickenpox in children
When the first symptoms of chickenpox appear, the child should be immediately shown to the doctor for an accurate diagnosis.
First of all, for the prevention of possible complications it is necessary to observe strict bed rest during the entire febrile period.
To detoxify the body shows the use of a large amount of fluid, but it should be remembered that excessive sweating can worsen the skin rash through their suppuration.
The virus of chicken pox refers to intracellular pathogens, which means that it is practically impossible to influence it with medicinal preparations without damaging the cells of its own organism.
The use of such an antiviral drug as interferon has not found application in a wide clinical practice. It is believed that this drug can somewhat reduce the external manifestation of the disease, as well as reduce the surface area of the rashes. Sometimes doctors can prescribe drugs of cyclic nucleotides (acyclovir and its analogs).
Many doctors widely practice the appointment of homeopathic remedies and traditional medicine. For example, flacoside, alpisarin and chelepin are recommended for use.
Since chickenpox belongs to the class of viral diseases, the use of antibiotics in this case is not shown.
In cases of fever in children, anti-inflammatory drugs such as ibuprofen or paracetamol can be used.
Necessarily appointment of local treatment. So, it is good to treat the dried up morphological elements with local antiseptics (methylene blue, Castellani solution). If possible, it shows the use of ultraviolet rays to accelerate the formation of crusts.
How to prevent chickenpox?
With regard to the prevention of varicella, the opinions of scientists vary radically. Some believe that it is necessary to specifically infect the children so that they become ill with this infectious disease. Others, on the contrary, believe that prolonged persistence of the virus in autonomic ganglia can lead to the development of severe complications. One of the means of specific prevention of chickenpox is vaccination (Oakwax, Varilrix).
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