Volume 03 Issue 08-2023
64
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
08
P
AGES
:
64-71
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
Chickenpox, caused by the varicella-zoster virus (VZV), is a highly contagious viral infection primarily affecting children
but can also occur in adults. This abstract provides an overview of the clinical features of chickenpox at the present
stage. The incubation period ranges from 10 to 21 days, followed by a prodromal phase characterized by nonspecific
symptoms. The hallmark clinical feature is the development of a characteristic rash, starting as red macules and
progressing into fluid-filled vesicles that crust over. Itching is a common symptom associated with the rash. Fever,
typically mild to moderate, is a common accompaniment. Respiratory symptoms, such as cough, sore throat, or runny
nose, may occur in some cases. General discomfort, including div aches and headache, is also observed. Awareness
of these clinical features aids in early diagnosis and appropriate management. Preventive measures, including
vaccination, are crucial for reducing the incidence and severity of chickenpox.
From January 2022 to December 2022, 201 patients aged 2 months to 52 years were treated at the Bukhara Regional
Infectious Diseases Hospital, including 126 (63%) children aged 2 months to 17 years and 75 (37%) adults aged 18 to 52
years. patients, most of whom were men. Epidemiological and anamnestic anamnesis, the clinical course of the
disease, and clinical-laboratory results were analyzed in all patients, and characteristics of the clinical course in children
and older patients with chicken pox were studied.
KEYWORDS
Chickenpox, rash, vesicle, pustulation, fever, lymphadenopathy.
INTRODUCTION
Research Article
PRESENT STAGE CLINICAL MANIFESTATIONS OF CHICKENPOX
Submission Date:
August 20, 2023,
Accepted Date:
August 25, 2023,
Published Date:
August 30, 2023
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume03Issue08-09
Gulnora Amirqulovna Arashova
Bukhara State Medical Institute Named After Abu Ali Ibn Sina, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 03 Issue 08-2023
65
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
08
P
AGES
:
64-71
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
Chickenpox, caused by the varicella-zoster virus (VZV),
is a highly contagious viral infection that primarily
affects children but can also occur in adults. Despite
advancements in medical knowledge and treatment
options, the clinical features of chickenpox have
remained
relatively
consistent
over
time.
Understanding the clinical presentation of chickenpox
is crucial for accurate diagnosis and appropriate
management. In this article, we will explore the clinical
features of chickenpox at the present stage.
Incubation Period and Prodromal Phase. After
exposure to the varicella-zoster virus, there is an
incubation period that lasts between 10 and 21 days.
Following this period, the prodromal phase occurs,
characterized by nonspecific symptoms that precede
the appearance of the characteristic rash. Symptoms
during this phase may include mild fever, headache,
fatigue, loss of appetite, and general malaise.
Rash. The hallmark clinical feature of chickenpox is the
development of a characteristic rash. The rash typically
starts as small, red, itchy spots known as macules,
which quickly progress into fluid-filled blisters called
vesicles. These vesicles then undergo a process of crust
formation and eventually scab over. The rash tends to
appear in successive crops, meaning new lesions
continue to emerge for several days. It can affect the
entire div, including the face, trunk, and extremities.
Itching. The rash associated with chickenpox is often
intensely itchy, leading to discomfort for the affected
individual. The urge to scratch the lesions can be
strong, but it is important to avoid excessive scratching
to prevent complications such as secondary bacterial
infections and scarring. Measures to manage itching,
such as calamine lotion, antihistamines, and keeping
the nails short, can help alleviate discomfort.
Fever. Fever is a common symptom of chickenpox,
especially during the initial phase of the illness. The
fever is typically mild to moderate in intensity but can
occasionally be higher, particularly in adults. Over-the-
counter fever reducers, as recommended by a
healthcare professional, can be used to alleviate fever
and associated discomfort.
Respiratory Symptoms. In some cases, chickenpox may
be accompanied by respiratory symptoms such as a
cough, sore throat, or runny nose. These symptoms are
usually more prominent in adults or individuals with
weakened immune systems. It is important to manage
these symptoms through rest, hydration, and
appropriate over-the-counter medications under
medical guidance.
General Discomfort. Chickenpox can cause general
discomfort, including div aches and headache. Rest,
hydration, and over-the-counter pain relievers can help
alleviate these symptoms.
Volume 03 Issue 08-2023
66
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
08
P
AGES
:
64-71
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
Chickenpox continues to present with consistent
clinical features at the present stage. Recognizing the
typical signs and symptoms, such as the characteristic
rash, itching, fever, and respiratory symptoms, is
crucial for prompt diagnosis and appropriate
management. While chickenpox is usually a self-
limiting illness, certain high-risk groups may require
additional medical attention. If you suspect you or
someone you know has chickenpox, it is advisable to
seek medical advice for proper diagnosis and guidance
on symptom management.
Remember, prevention through vaccination is the best
approach to protect against chickenpox. Vaccination
not only reduces the risk of contracting the disease but
also minimizes the severity of symptoms in
breakthrough cases.
Chickenpox is one of the most widespread highly
contagious infections, the susceptibility to which
reaches 95-100% [1]. Against the background of a
decrease in the incidence of “controlled” infections in
the structure of infectious pathology, the importance
of chickenpox increases. The urgency of the problem is
determined by the high incidence of chickenpox, the
ubiquitous spread of the pathogen, the increase in the
share in the general infectious pathology, significant
economic damage, and the ineffectiveness of
preventive measures implemented in practice
(isolation of patients, quarantine). Chickenpox is an
acute viral disease predominantly in childhood,
however, given its wide distribution and high
contagiousness, it often occurs in the adult population,
when the disease is more severe and the percentage of
complications is higher. [1,2]. The current epidemic
process of varicella is characterized by a tendency for
the infection to “grow up”, especially among the urban
population. Every year, 5 to 6% of cases are adults. The
number of sick adolescents aged 15 to 17 years is 3-5%
[2,3].
Over the past 5 years, the incidence rate among the
adult population has increased 5 times. The greatest
risk of an unfavorable course of chickenpox is in
persons with an immunodeficiency state of any
genesis, affecting the cellular link of immunity.
THE PURPOSE OF OUR RESEARCH
The goal is to study the clinical features of chickenpox
in patients hospitalized in the department of the
Bukhara Infectious Diseases Hospital in 2022 year, and
to conduct a comparative analysis of the clinical course
of the disease in children and patients over 18 years of
age.
MATERIALS AND METHODS
Under observation were 201 sick children and adults
aged from 2 months to 52 years with a diagnosis of
chicken pox, who were admitted to the department of
the Bukhara Infectious Diseases Hospital from January
2022 to December 2022. Among them, 126 (63%) were
Volume 03 Issue 08-2023
67
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
08
P
AGES
:
64-71
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
aged from 2 months to 17 years, 120 from 2 months to
14 years, from 2 months to 5 years - 75, from 2 months
to 1 year - 30, from 18 years to 52 years was 75 (37%)
were dominated by men, predominantly aged 18 to 52
years.
The diagnosis of chicken pox was established on the
basis of complaints, medical history and objective data.
In all patients, the data of the epidemiological
anamnesis and the anamnesis of the development of
the disease, the clinical course of the disease were
analyzed, a clinical and laboratory examination was
carried out, which made it possible to identify the
clinical features of this disease at the present stage.
RESULTS AND DISCUSSION
As is known, for various infectious diseases, an
epidemiological history is important for making a
diagnosis, which allows you to identify the source of
the infection and timely start anti-epidemic measures
both in organized groups and closed institutions and in
family foci. From the epidemiological history, it was
found that 175 patients (87%) had contact with patients
with chickenpox, and the remaining 14 patients (7%)
were hospitalized not only for clinical but also for
epidemiological indications: persons living in hostels in
12 cases (6%) did not have direct contact with patients
with chickenpox.
Observations showed that the clinical symptoms of
chickenpox in adults did not differ from those in
children, but the disease was much more severe. Thus,
in 82.8% of patients the course of the disease was
0
50
100
150
200
250
From 2 months to 52 years
From 2 months to 17 years
sick children and adults
From 2 months to 17 years
From 18 years old to 52 years
old
From 2 months to 14 years
2 months to 5 years
2 months to 1 year
Volume 03 Issue 08-2023
68
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
08
P
AGES
:
64-71
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
regarded as moderate, in 9.0% as severe, and only 8.2%
as mild. The severity of the disease was determined by
the severity of symptoms of intoxication, temperature
reaction, and the nature of the rash. In typical cases,
the disease developed acutely (82%) or subacutely
(18%).
An analysis of the clinical course of the disease in
children showed that in (88%) children the disease
developed acutely from the prodromal period (1-2
days), during which malaise, weakness, fever from sub
febrile to high (39 ° C) figures were noted,
capriciousness, tearfulness, poor appetite. For
outpatient medical care, 94% of patients applied during
the first day (1-2 days) from the onset of the disease to
the appearance of the first elements of the rash.
According to the literature, chickenpox in adults is
characterized by a longer prodromal period, if in
children it is 24-72 hours, then in adults it can reach 7-10
days, thereby making timely diagnosis difficult and
increasing the risk of infection of contact persons. The
onset of the disease in adults 46 (60%) patients was
acute, in 30 patients (40%) - subacute onset with a
prodromal period that lasted from 1 to 5 days.
The prodromal period in the patients we observed
lasted from 1.5 to 5 days, during which there was an
increase in div temperature from sub febrile to high
numbers (39-40) ° C, malaise, headache, general
weakness,
decreased
performance,
lethargy,
drowsiness in all 62 adult patients. In most cases, an
increase in div temperature was noted on the first
day of illness - in 44 (71 %) patients, however, in 11 (18%)
patients this symptom appeared on the second day of
illness, in 4 (6%) on the 3rd-4th day of illness, and in 3
(5%) it was short-term within one day (rising
temperatures up to 37.2-37.5°C). Hospitalization of
patients was carried out during the period of rashes on
the 2-4th day of illness in 60 (97%) cases. However,
hospitalization was also noted in the later stages of the
disease - on the 5-6th day in 3% (2 people) of cases.
The period of rash began mainly with the appearance
of one or two large maculopapular elements, very
quickly turning into vesicles or pustules. Over the next
day, the papular-vesicular rash increased rapidly and
spread with a sprinkling to the face, scalp (44.7%),
behind the ear (26.8%) or simultaneously on the scalp
and behind the ear (28, 5%). In the next 1-4 days, the
rash began to spread to the face, neck, trunk, and
upper and lower extremities. At the same time, in 54
(87%) patients on the lower extremities, the rash was
scanty. Sleeping continued in 53 (85%) patients for 3-4
days, accompanied by skin itching. Within a few hours,
the rash became vesicular, then gradually began to dry
out with the formation of crusts, which completely
disappeared on the 7-12th day. In 36 (58%) patients, the
rash was extremely profuse, almost completely
covering the face and trunk. During the height of the
disease in children, rashes were plentiful, especially on
Volume 03 Issue 08-2023
69
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
08
P
AGES
:
64-71
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
the trunk and extremities, accompanied by skin itching
in 38% of patients; in some patients (23%), enanthema
was found on the mucous membranes of the oral
cavity; The period of rashes lasted an average of 3-4
days. In 42% of cases, lymphadenopathy was diagnosed
with an increase in cervical, axillary and inguinal lymph
nodes. A distinctive feature of the rash in adults was
rapid and profuse pustulization, which was observed in
almost half of 26 (42%) patients. Pustulization was
accompanied by a significant (39-40) °C rise in
temperature, and pyoderma was so pronounced that it
required additional antibiotic therapy, and in 7 cases
(11%) the disease had a severe severity associated with
the severity of pyoderma and existing concomitant
pathology. It was characterized by high temperature
(39-40) °C from the first days of illness, severe
intoxication, manifested by headache, dizziness,
severe weakness, sleep disturbance, nausea, repeated
vomiting, lack of appetite, as well as profuse rash, with
severe itching, pustulization and symptoms of
comorbidities.
In all patients, at the height of the disease, catarrhal
phenomena were observed, such as a runny nose, dry
cough, and lacrimation. In 36 patients (58%), rashes
were observed on the conjunctiva, which was
accompanied by the development of scleritis and
conjunctivitis within 3-5 days of the rash period.
Exanthema in 94% of cases was accompanied by
enanthema on the oral mucosa, mainly in the region of
the palatine arches and soft palate. Thus, the
oropharyngeal mucosa was brightly hyperemic in 23
(24%) patients, moderate hyperemia was observed in
18 (27%), and weak in 31 (47%), while all of them had
graininess of the tonsils, arches and posterior
pharyngeal wall. The enanthema first looked like bright
pink papules, and then turned into vesicles, which
quickly opened with the formation of ulcers covered
with a white-yellow coating. 8% of patients developed
stomatitis, which caused severe pain when eating.
It should also be noted that the period of rashes was
accompanied by intoxication and asthenovegetative
syndromes: severe headache in 57 (92%) patients,
malaise and weakness in all 62 adults (100%) patients;
32 (52%) patients had pain in the lumbar region, 5 (8%)
patients had nausea, vomiting, abdominal pain.
High fever was recorded in 47 (76%) patients - an
increase in div temperature to (38.8-39.9) ° C, in 15
(24%) patients subfebrile temperature was noted. The
feverish period in uncomplicated cases lasted 6-7 days,
with the development of complications it lengthened
to 9-10 days. Usually the temperature returned to
normal with the end of the period of pouring.
In 92% of cases, the disease was accompanied by
lymphadenopathy with a predominant increase in
cervical and behind-the-ear lymph nodes. With
pustulization, lymphadenopathy was expressed
Volume 03 Issue 08-2023
70
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
08
P
AGES
:
64-71
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
especially sharply. Enlarged lymph nodes were
determined visually when the head was tilted.
CONCLUSIONS
Thus, in the structure of hospitalized patients with a
verified diagnosis of chickenpox, children aged 3 to 14
years significantly predominated (120) and adults from
18 to 52 years old was 75, more often males were sick.
Chicken pox, both in adults and in children, it
proceeded typically, with severe cyclicity, the presence
of leading symptoms of the disease and was
characterized in most cases by more severe
complications, unlike children, in adults, it was
manifested by a long prodromal period, a pronounced
general infectious syndrome, lymphadenopathy ,
abundant polymorphic rash with itching, with a
duration of rashes from 5 to 8 days and early
pustulation, enanthema with scleritis and conjunctivitis
was noted. The uneven course of the disease was
accompanied by the development of complications in
persons with a premorbid background, in elderly
people (pneumonia, encephalitis, etc.).
REFERENCES
1.
Sergeeva I.V., Lipnyagova S.V., Beckert A.I.,
Levitsky S.V., Borisov A.G. Modern features of
the course of chickenpox//Modern problems of
science and education.- 2015.
–
No. 5 .
2.
Sitnik, T.N. Chicken pox: “grown
-
up” infection
/ T.N. Sitnik, L.V. Steinke, N. V. Gabbasova //
Epidemiology and vaccinal prevention: journal.
- 2018. - No. 17 (5). -
55−58s.
3.
Chickenpox in children in modern conditions
(epidemiology, clinic, diagnosis, therapy,
prevention): a medical guide for doctors / ed.
Yu.V. Lobzin. SPb., 2011. 80 p.
4.
Martynova G.P., Kutishcheva I.A., Evreimova
S.V., Karasev A.V. et al. Clinical and
epidemiological features of chickenpox at the
present stage // Infectious. illness. 2012. V. 10,
No. 4. S. 18
–
22.
5.
Vikulov G.Kh. Human herpesvirus infections in
the
new
millennium:
classification,
epidemiology
and
medical
and
social
significance // Epidemiology and infectious
diseases. 2014. No. 3. P. 35
–
40.
6.
Zheleznikova G.F., Lobzin Yu.V., Skripchenko
N.V., Ivanova G.P. Clinical significance of serum
levels of cytokines in chicken pox in children //
Infection and Immunity. 2015. V. 5, No.1.S.79-
84.
7.
Infectious diseases: national guidelines / edited
by N.D. Yushchuk, Yu.Ya. Vengerov. M .:
GEOTAR - Media , 2009. 1040 p .
8.
Arashova G.A. On the issue of the course of
chickenpox in adults. 2019 Journal of Problems
of Biology and Medicine, Vol.1, No. 4.2, Pages 7-
9
Volume 03 Issue 08-2023
71
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
08
P
AGES
:
64-71
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
9.
Arashova G. A. Measles in adults. 2022. Journal
New Day in Medicine No. 2(40), Pages 556559
10.
Arashova GA Observation of the Immuno-
Pathogenetic State of Measles in Adults.
International journal of health systems and
medical sciences.Vol.1 NO. 5 (2022)
11.
Arashova G.A., Gulamov M. Kh. Morphological
and Functional Aspects of the Lymphatic
System and its Current Problems. International
Journal of Innovative
12.
Analyzes and Emerging Technology. 2021/10/5 T
-1, No. 5.-P. _ 149
–
152
13.
Arashova G.A. Clinical and epidemiological
features of measles in adults. 2022. Journal of
Infection, Immunity and Pharmacology Vol.1,
No. 2, Special Issue. Part 1. Pages 1217
14.
Varicella and herpes zoster vaccines : Who
position paper, June 2014: [ eng . ] // Weekly
epidemiological record. - 2014. - No. 25 (20
June). -268-289p.
—
Memorandum WHO By
wind smallpox.
