Hỗ trợ các biện pháp với các loại kem và thuốc kháng histamine tại chỗ; thuốc kháng virus (acyclovir, valacyclovir, famciclovir) cho tất cả người lớn với globulin miễn dịch varicella • hoặc thuốc kháng virus cho tiếp xúc dễ bị ức chế miễn dịch hoặc bệnh nhân mang thai | 202 Essentials of Diagnosis Treatment 8 Varicella Acute Chickenpox Zoster Shingles Essentials of Diagnosis Acute varicella fever malaise with eruption of pruritic centripetal papular rash vesicular and pustular before crusting lesions in all stages at any given time drop on rose petal is the first lesion Incubation period 14-21 days Bacterial infection pneumonia and encephalitis may complicate Reactivation varicella herpes zoster dermatomal distribution vesicular rash with pain often preceding eruption Differential Diagnosis Other viral infections Drug allergy Treatment Supportive measures with topical lotions and antihistamines antivirals acyclovir valacyclovir famciclovir for all adults with varicella Immune globulin or antivirals for exposed susceptible immunosuppressed or pregnant patients Acyclovir early for immunocompromised or pregnant patients severe disease eg pneumonitis encephalitis or ophthalmic division of trigeminal nerve involvement with zoster Corticosteroids combined with antiviral agent with rapid taper may diminish postherpetic neuralgia in older patients with zoster Pearl Epidemics are more frequent in winter and spring and in temperate climates. Reference Weller TH Varicella historical perspective and clinical overview. J Infect Dis 1996 174 Suppl 3 S306. pMiD 8896536 Chapter 8 Infectious Diseases 203 Mumps Epidemic Parotitis Essentials of Diagnosis Painful swollen salivary glands usually parotid may be unilateral Incubation period 12-24 days Orchitis or oophoritis meningoencephalitis or pancreatitis may occur Cerebrospinal fluid shows lymphocytic pleocytosis in meningoencephalitis with hypoglycorrhachia Diagnosis confirmed by isolation of virus in saliva or appearance of antibodies after second week Differential Diagnosis Parotitis or enlarged parotids due to other causes eg bacteria sialolithiasis cirrhosis diabetes starch ingestion Sjogren s syndrome sarcoidosis tumor Aseptic meningitis pancreatitis or orchitis due to other causes Treatment
