Last reviewed: April 2018
Last updated: May  2018



History and exam

Key diagnostic factors

  • presence of risk factors
  • fever
  • vesicular rash
  • vesicles on mucous membranes

Other diagnostic factors

  • pruritus
  • headache
  • fatigue/malaise
  • sore throat
  • tachycardia

Risk factors

  • age 1 to 9 years
  • exposure to varicella
  • unimmunised status
  • occupational exposure

Diagnostic investigations

Investigations to consider

  • polymerase chain reaction
  • viral culture
  • direct fluorescent antibody testing (DFA)
  • Tzanck smear
  • latex agglutination (LA)
  • enzyme-linked immunosorbent assay (ELISA)
  • complement fixation
  • ultrasound (pregnant women)
Full details

Treatment algorithm


Authors VIEW ALL

Consultant in Paediatric Infectious Diseases and Immunology

Royal Liverpool Children's Hospital (Alder Hey)




AR has been funded by GlaxoSmithKline as a consultant and has been reimbursed by CLB Behring following attendance at a European conference.

Dr Andrew Riordan would like to gratefully acknowledge Dr Steven Pergam, Dr Rupali Jain, and Dr Anna Wald, previous contributors to this topic.

Peer reviewers VIEW ALL


Outpatient & Pediatric Dermatology

59th Medical Wing/ SGOMD

Lackland Air Force Base

San Antonio



CMH declares that he has no competing interests.

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