Varicella [Herpes] zoster virus (VZV); human herpesvirus 3 (HHV3)
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Pathology
- VZV causes 2 distinct clinical entities in humans:
- chicken pox (primary infection)
- Herpes zoster or shingles (reactivation)
- transmission:
- inhalation of aerosolized respiratory droplets
- airborne precautions & contact precautions to prevent transmission of Herpes zoster[2]
- direct contact with open shingles lesion
- maternal-fetal transmission through placenta
- inhalation of aerosolized respiratory droplets
- reactivation:
- VZV becomes latent in dorsal root ganglion after primary infection
- VZV reactivates presumptively with a decline in immunity
Laboratory
- Varicella zoster virus identified by culture
- viral cultures take 2-3 weeks
- shell culture vial demonstrates cytopathic effect in 24-48 hours
- Varicella zoster virus serology
- Varicella zoster virus Ag in tissue
- Varicella-zoster virus DNA
- Varicella zoster strain type in isolate
- see ARUP consult[3]
Management
- acyclovir is the only agent recommended for treatment of varicella
- prophylaxis
- varicella virus vaccine
- varicella immune globulin in immunocompromised or pregnant patients within 96 hours of exposure
- airborne precautions & contact precautions to prevent transmission of Herpes zoster[2]
More general terms
Additional terms
- chickenpox
- Herpes zoster (shingles)
- varicella virus vaccine (Varivax)
- varicella-zoster immune globulin (VZIG)
- Varicella-zoster virus DNA
References
- ↑ Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 864-67
- ↑ 2.0 2.1 2.2 Medical Knowledge Self Assessment Program (MKSAP) 15, 16, 17, 18. American College of Physicians, Philadelphia 2009, 2012, 2015, 2018.
- ↑ 3.0 3.1 ARUP Consult: Varicella-Zoster Virus - VZV The Physician's Guide to Laboratory Test Selection & Interpretation https://www.arupconsult.com/content/varicella-zoster-virus
- ↑ Fisher JP, Bate J, Hambleton S. Preventing varicella in children with malignancies: what is the evidence? Curr Opin Infect Dis. 2011 Jun;24(3):203-11 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21455062
- ↑ Gershon AA, Gershon MD. Pathogenesis and current approaches to control of varicella- zoster virus infections. Clin Microbiol Rev. 2013 Oct;26(4):728-43. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24092852 Free PMC Article