[NP-Clinical] chicken pox?

[Rhoda Friend]

Priscilla,

A point of interest: I had an unusual experience a couple years back, 
but it taught me to watch these strange looking rashes more closely.  
Female, age 12 presented with app 0.5 cm lesions sparsely scattered over 
trunk and upper limbs.  Not vesicular, more like red, oapular, but 
almost urticarial-looking lesions--looked like a reaction to something.  
No fever, and child was not ill at all, just itchy.  After 24 hours with 
no improvement, but a little spreading, I sent her on to PCP (this was a 
school clinic, and I had no testing facilities and few lab options).  
Turned out to be atypical chicken  pox, which is contagious and 
reportable.  I've been told that this is on the rise in the 
varicella-immunized population, as is Herpes Zoster.  It didn't look 
anything like the usual chickenpox, and I would have never thought of 
that in the differential, particularly since the child had been immunized.

Rhoda Friend

Priscilla Merrill wrote:
>
> What is your office setting?  Unless highly immunocompromised patients 
> on a routine basis, I see no problem.  She probably had them herself 
> as a child so shouldn’t be contagious as her immunity should’ve kicked 
> in.  I agree that this is not a highly virulent strain of chicken pox 
> since the child was immunized.  Folks are exposed to so much anyway in 
> the general public that I think as long as she follows Universal 
> Precautions (hand washing stressed to her as a gentle reminder) that 
> there should be no problem coming to work.
>
>  
>
> Priscilla Merrill
>
>  
>
> ------------------------------------------------------------------------
>

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