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Chickenpox


Acute viral disease, predominantly of children from 6 months. up to 7 years In adults, the disease is less common. Source of infection
- A sick person who presents a danger from the end of the incubation period until the crusts fall. The pathogen belongs to the group of herpes viruses and is distributed by airborne droplets.
Symptoms and course:
The incubation period lasts an average of 13-17 days. The disease begins with a rapid rise in temperature and the appearance of a rash on various parts of the body. At the beginning, these are pink spots of 2-4 mm in size, which in a few hours turn into papules, then into vesicles — bubbles filled with transparent contents and surrounded by a rim of hyperemia. In place of bursting vesicles dark red and brown crusts form, which disappear in 2-3 weeks. Polymorphism of a rash is characteristic: on a separate site of skin it is possible to meet spots, vesicles, papules and crusts at the same time. On the mucous membranes of the respiratory tract (pharynx, larynx, trachea) occur enanthema. These are bubbles that quickly turn into a sore with a yellowish-gray bottom, surrounded by a red rim. Duration of the feverish period is 2-5 days. The course of the disease is benign, but severe forms and complications can be observed: encephalitis, myocarditis, pneumonia, false croup, various forms of pyoderma, etc.
Recognition is based on the typical cyclical nature of the development of rash elements. Laboratory tests can detect the virus using a light microscope or immunofluorescence method.
Treatment:
There is no specific and etiotropic treatment. It is recommended to observe bed rest, to monitor the cleanliness of clothes and hands. Elements of the rash lubricate 5% solution of potassium permanganate or 1% solution of brilliant green. In severe forms, immunoglobulin is administered. For purulent complications (abscesses, bullous streptoderma, etc.), antibiotics (penicillin, tetracycline, etc.) are prescribed.
Prevention:
Isolation of the patient at home. Children of toddlers and preschool children who were in contact with the patient are not allowed in children's institutions until 21 days. Immunoglobulin (3 ml intramuscularly) is injected into weakened children who have not had varicella.
Viral hepatitis. Infectious diseases occurring with general intoxication and primary damage to the liver. The term "viral hepatitis" combines two main nosological forms - viral hepatitis A (infectious hepatitis) and viral hepatitis B (serum hepatitis). In addition, currently a group of viral hepatitis "neither A nor B" has been identified. Pathogens are quite stable in the environment. In viral hepatitis A, the source of infection is the patients at the end of the incubation and pre-yellowing period, because at this time the pathogen is excreted in the stool and is transmitted through food, water, household items when hygiene is not observed, and contact with the patient. In viral hepatitis B, the source of infection is patients in the acute stage, as well as carriers of the hepatitis B antigen. The main route of infection is parenteral (through the blood) when using non-sterile syringes, needles, dental, surgical, gynecological and other instruments. Infection through blood transfusion and its derivatives is possible.
Symptoms and course:
The incubation period for viral hepatitis A ranges from 7 to 50 days; for viral hepatitis B, it ranges from 50 to 180 days. The disease proceeds cyclically and is characterized by the presence of periods - predzheltushny, icteric, post-yellowy, rolling in the period of convalescence. The preicteric period of viral hepatitis A in half of the patients occurs as a flu-like variant, characterized by an increase in body temperature to 38-39 ± C, chills, headache, aching pain in the joints and muscles, sore throat, and so on. In the dyspeptic variant, pain and heaviness in the epigastric region, loss of appetite, nausea, vomiting, and sometimes an increase in stool come to the fore. With asthenovegetative variant, the temperature remains normal, there is weakness, headache, irritability, dizziness, impaired performance and sleep. For the predental period of viral hepatitis B, the most characteristic are breaking pains in large joints, bones, muscles, especially at night, sometimes the appearance of joint swelling and reddening of the skin. At the end of the preicteric period, the urine becomes dark, and the stool becomes discolored. The clinical picture of the icteric period of viral hepatitis A and viral hepatitis B is very similar: ikterichnost sclera, mucous membranes of the oropharynx, and then the skin. The intensity of jaundice (icterus) increases during the week. Body temperature is normal. There are weakness, drowsiness, loss of appetite, aching pain in the right hypochondrium, in some patients itchy skin. The liver is enlarged, compacted and somewhat painful on palpation, an increase in the spleen. In the peripheral blood, leukopenia, neutropenia, and relative lympho- and monocytosis are found. ESR 2-4 mm / h. In the blood, the total bilirubin content is increased, mainly due to direct (bound). The duration of the icteric period of viral hepatitis A is 7-15 days, and viral hepatitis B is about a month.
A terrible complication is an increase in liver failure, manifested by impaired memory, increased general weakness, dizziness, agitation, increased vomiting, an increase in the intensity of icteric skin color, a decrease in liver size, the appearance of hemorrhagic syndrome (vascular bleeding), ascites, fever, neutrophilic leukocytosis. bilirubin and other indicators. A frequent end result of liver failure is the development of hepatic encephalopathy. With a favorable course of the disease after jaundice, a recovery period begins with the rapid disappearance of the clinical and biochemical manifestations of hepatitis.
Recognition:
Based on clinical and epidemiological data. The diagnosis of viral hepatitis A is established taking into account the stay in the infectious focus 15–40 days before the disease, a short preicuscid period, usually with a flu-like variant, the rapid development of jaundice, a short icteric period. The diagnosis of viral hepatitis B is established if at least 1.5–2 months before the appearance of jaundice the patient was transfused with blood, plasma, surgical interventions, and multiple injections. Confirm the diagnosis of laboratory parameters.
Treatment:
Etiotropic therapy pet. The basis of treatment is a regimen and proper nutrition. The diet should be complete and high-calorie, exclude from the diet fried foods, smoked meat, pork, lamb, chocolate, spices, alcohol is absolutely prohibited. It is recommended to drink plenty of liquids up to 2-3 liters per day, as well as a complex of vitamins.
In severe cases, conduct intensive infusion therapy (intravenous 5% glucose solution, hemodez, etc.). With the threat or development of liver failure, corticosteroids are shown.
Prevention:
Given the fecal-oral mechanism of transmission of viral hepatitis A, it is necessary to control food, water supply, and personal hygiene. For the prevention of viral hepatitis B, careful monitoring of donors, high-quality sterilization of needles and other tools for parenteral procedures.