Patient Case: Chickenpox (Varicella)
A 6-year-old girl is brought to the pediatric clinic by her mother with a two-day history of fever, fatigue, and an itchy skin rash. The mother reports that the rash started as small red spots on her daughter’s face and chest before spreading to her back, arms, and legs. Over the past 24 hours, the spots have evolved into fluid-filled blisters, some of which are beginning to crust over.
The child has no significant past medical history and is otherwise healthy. However, her mother mentions that she has not received the varicella vaccine. Additionally, several of her classmates at school have recently been sent home with similar symptoms.
On examination, the child appears slightly uncomfortable due to itching but is alert and responsive. She has a temperature of 38.5°C (101.3°F). Her skin exam reveals multiple stages of rash development, including red macules, vesicles, and crusted lesions in different areas of the body. Some lesions are present on the scalp and inside the mouth.
Based on the classic clinical presentation, a diagnosis of chickenpox (varicella) is made. The mother is advised to keep the child at home to prevent further spread, manage symptoms with antihistamines for itching, acetaminophen for fever, and ensure good skin hygiene to prevent secondary bacterial infection. Since the child is otherwise healthy, no antiviral treatment is required, but the importance of varicella vaccination for future protection is discussed.
- Which of the following best describes the characteristic rash of chickenpox (varicella)?
A) Red maculopapular rash that spreads from face to trunk without vesicles
B) Vesicular rash that appears in crops and progresses through different stages
C) Target-like lesions with central clearing
D) Thick, scaly plaques with well-defined borders - Why is it important to keep this child at home during the illness?
A) Chickenpox can spread through direct contact and airborne droplets
B) The child needs complete isolation because chickenpox is only spread through bodily fluids
C) The child should be kept indoors to avoid worsening symptoms from sunlight
D) Chickenpox does not spread easily, so isolation is unnecessary - Which of the following is a potential complication of varicella in healthy children?
A) Postherpetic neuralgia
B) Secondary bacterial skin infections
C) Rheumatic fever
D) Chronic joint pain - What is the best method for preventing chickenpox in children?
A) Avoiding contact with infected individuals
B) Receiving the varicella vaccine
C) Taking antiviral medication as a preventive measure
D) Using antibiotics to prevent infection
