[NP-Clinical] Chicken pox

[Mary Beck]

Hi Ann,
 "Nerve root" is what I meant to type. Here's an article that talks about herpes viruses, but I believe the info about antibody response is common to both viral infections:
http://www.ashastd.org/herpes/herpes_learn_testing.cfm

"The challenge here is that the time it takes for IgG antibodies to reach detectable levels can vary from person to person. For one person, it could take just a few weeks, while it could ta ke a few months for another. So even with the accurate tests, a person could receive a false negative if the test is taken too soon after contracting the virus. For the most accurate test result, it is recommended to wait 12 - 16 weeks from the last possible date of exposure before getting an accurate, type-specific blood test in order to allow enough time for antibodies to reach detectable levels."

Mary


  ----- Original Message ----- 
  From: arezendes at aol.com 
  To: np-clinical at nurse.net 
  Sent: Wednesday, August 01, 2007 8:16 AM
  Subject: Re: [NP-Clinical] Chicken pox


  Hello Mary,
  The lesions are all over the trunk, back, face, forehead, scalp, back of neck, with limited lesions on the extremities. He did have fever, chills, malaise, etc a week or two ago, but this has resolved. He also has Type 1 DM on insulin pump. Do you know the time frame for IGM antibodies to show up? 
  Thank you,
  Ann


  -----Original Message-----
  From: Mary Beck <mary.beck at charter.net>
  To: NP Clinical <np-clinical at nurse.net>
  Sent: Wed, 1 Aug 2007 9:04 am
  Subject: Re: [NP-Clinical] Chicken pox


  Hi Ann,
    Are you sure it's chicken pox and not zoster? Are the lesions on one side or generalized over the entire trunk? Usually adults with chicken pox are sicker-fever, headache, malaise, anorexia. I've found that the sensations along the involved nerve route with herpes zoster and herpes simplex 2 can range from decreased sensation/numbness to tingling, extreme pain and burning. Your varicella titer might not be positive because it's too early to mount a sufficient antibody response. Supportive care is prudent, as is avoiding pregnant women, immunocompromised people, etc.

  Mary Beck, NP
    
    ----- Original Message ----- 
    From: arezendes at aol.com 
    To: np-clinical at nurse.net 
    Sent: Tuesday, July 31, 2007 7:14 PM
    Subject: [NP-Clinical] Chicken pox


    Hello listmates, 
    I saw a 40 year old male with an initial case of chicken pox today. Actually he called a week or so ago with symptoms consistent with chicken pox. He came in today complaining about a decreased sensation in his trunk and back area where the lesions are. The lesions are in various stages of healing (no acute vesicles, just scabbing and redness). No fever, chills, body aches, actually feeling much better than he looked. I drew a CBC and varicella titers, and told him to treat his symptoms. I am not sure if the "decreased sensation" is related to the disease, nerve irritation from the virus, etc. as I have never treated someone for this. He is not having any numbness or tingling. Any thoughts? My collaborative MD was out today.
    Thanks ahead,
    Ann NP 

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