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Varicela-zóster aguda

最后审阅: 14 Aug 2025
最后更新: 31 May 2024

小结

定义

病史和体格检查

关键诊断因素

  • presença de fatores de risco
  • febre
  • erupção cutânea vesicular
  • vesículas em membranas mucosas
完整详情

其他诊断因素

  • prurido
  • cefaleia
  • fadiga/mal-estar
  • faringite
  • taquicardia
完整详情

危险因素

  • exposição à varicela
  • idade entre 1 e 9 anos
  • estado não imunizado
  • exposição ocupacional
完整详情

诊断性检查

首要检查

  • diagnóstico clínico
完整详情

需考虑的检查

  • reação em cadeia da polimerase
  • cultura viral
  • teste de anticorpo fluorescente direto (AFD)
  • esfregaço de Tzanck
  • aglutinação em látex (AL)
  • ensaio de imunoadsorção enzimática (ELISA)
  • fixação de complemento
  • ultrassonografia (gestantes)
完整详情

治疗流程

急症处理

crianças saudáveis com baixo risco de contrair a forma mais grave da doença

aumento do risco de doença moderada a grave

alto risco de contrair a forma mais grave da doença

doença grave

撰稿人

作者

Andrew Riordan, MD, FRCPCH, MRCP, DTM&H

Consultant in Paediatric Infectious Diseases and Immunology

Royal Liverpool Children's Hospital (Alder Hey)

Liverpool

UK

Disclosures

AR declares that he has no competing interests.

Acknowledgements

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

Disclosures

SP has served as a consultant for Merck & Co., Inc, Optimer/Cubist, and Chimerix, and has participated in clinical trials with these three organizations. He is also an author of a paper cited in this topic. RJ declares that she has no competing interests. AW is a member of the Data and Safety Monitoring Board (DSMB) for a Merck study of a candidate VZV vaccine.

Peer reviewers

Chad M. Hivnor, Major, USAF, MC, FS

Chief

Outpatient & Pediatric Dermatology

59th Medical Wing/ SGOMD

Lackland Air Force Base

San Antonio

TX

Disclosures

CMH declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

UK Health Security Agency. The Green Book: Varicella. Jun 2019 [internet publication].Full text

Marin M, Güris D, Chaves SS, et al; Centers for Disease Control and Prevention. Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2007 Jun 22;56(RR-4):1-40.Full text  Abstract

Royal College of Obstetricians and Gynaecologists. Chickenpox in pregnancy (Green-top guideline no. 13). January 2015 [internet publication].Full text

American Academy of Pediatrics. Varicella-zoster virus infections. In: Kimberlin DW, ed. Red book 2021- 2024: report of the Committee on Infectious Diseases. 32nd ed. Elk Grove Village, IL: American Academy of Pediatrics; 2021; 831-43.Full text

Pergam SA, Limaye AP, AST Infectious Diseases Community of Practice. Varicella zoster virus in solid organ transplantation: guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019 Sep;33(9):e13622. Abstract

Centers for Disease Control and Prevention. Chickenpox (varicella). For healthcare professionals. Oct 2022 [internet publication].Full text

Centers for Disease Control and Prevention. Updated recommendations for use of VariZIG - United States, 2013. MMWR Morb Mortal Wkly Rep. 2013 Jul 19;62(28):574-6.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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