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Complications

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Majority of children recover without any complications but neonates, adults, pregnant women and those who are immunocompromised may have more serious complications (1). Complications include:

Pulmonary involvement:

  • between 5 and 14% of adults will have pulmonary involvement
  • pneumonia - particularly in adults; also pneumonia caused by the chicken pox virus itself
    • the risk is increased in pregnant women, the immunocompromised, those with pre-existing lung disease (not including asthma), and smokers (2)

Central nervous system involvement:

  • cerebellar ataxia – usually seen during the recovery period
  • encephalitis:
    • rarely seen in adults (2)
    • classically presenting with ataxia 3 to 4 days after onset of rash, although sometimes up to 8 days, often affecting the cerebellum
    • 80% make a full recovery

Secondary bacterial infections:

  • bacterial infection of lesions
  • common organisms include Staphylococcus aureus or Group A Streptococci
  • skin and soft tissue infection, osteomyelitis, septicaemia or toxic shock syndrome may occur (2)

Haemorrhagic complications

  • pulmonary and gastrointestinal bleeding
  • intra-cerebral haemorrhage
  • disseminated intravascular coagulation (2)

In pregnancy:

  • considerable maternal morbidity
  • congenital varicella syndrome in 10% if infected in first 20 weeks of gestation

Less common complications include

  • arthritis, glomerulonephritis, myocarditis, and purpura fulminans (3)

Reference:


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