Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
When monitoring patients with chickenpox, you should be aware of several potential complications:
- Bacterial Superinfection: This is a common complication, affecting 32% of children and 17% of adults admitted to hospital with chickenpox in one UK study NICE CKS Bovill 1998. Monitor for a sudden high-grade fever (pyrexia), especially after initial improvement, along with redness (erythema) and tenderness surrounding the original chickenpox lesions NICE CKS.
- Dehydration: Encourage and monitor fluid intake NICE CKS. Advise patients to seek medical attention if signs of dehydration develop, such as reduced urine output, lethargy, cool peripheries, or reduced skin turgor NICE CKS.
- Serious Complications: Less common but severe complications include pneumonia, encephalitis, and severe secondary bacterial infection of the skin NICE CKS. If these are suspected, the patient should be admitted to hospital NICE CKS.
Patients at increased risk of complications include:
- Adults: Adults are more likely to develop complications than children NICE CKS.
- Smokers and those with chronic conditions: People who smoke, have severe lung or cardiovascular disease, or a chronic skin disorder are particularly at risk NICE CKS PHE 2015Kimberlin 2018.
- Pregnant Women: Pregnant women are at higher risk of serious complications, such as fulminating varicella pneumonia, with the risk being greatest in the second and early third trimesters NICE CKS PHE 2015. There is also a small risk of fetal varicella syndrome if chickenpox develops in the first 28 weeks of pregnancy NICE CKS RCOG 2015.
- Immunocompromised Individuals: This includes people receiving cancer treatment, high doses of oral steroids, or those with conditions that reduce immunity NICE CKS.
- Infants: Infants aged 4 weeks or less are also at increased risk NICE CKS.
It is important to advise patients to seek urgent medical advice if their condition deteriorates or if they develop any of these complications NICE CKS.