Shingles and Chickenpox (Varicella-Zoster Virus) - Risk Factors

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Highlights	Symptoms	Treatment for Shingles
Introduction	Diagnosis	Treatment for Postherpetic Neuralgia
Risk Factors	Vaccination	Resources
Complications	Treatment for Chickenpox	References

Secondary Skin Infections and Scarring. Small scars may remain after the scabs have fallen off, but they usually clear up within a few months. In some cases, a secondary infection may develop at sites which the patient has scratched. The infection is usually caused by the bacteria Staphylococcus aureus or Streptococcus pyogenes. Permanent scarring may occur as a result. Children with chickenpox are at much higher risk for this complication than adults are, possibly because they are more likely to scratch.

Bacterial superinfection of the skin caused by group A streptococcus is the most common serious complication of chickenpox (but it is still rare). The infection is usually mild, but if it spreads in deep muscle, fat, or in the blood, it can be life threatening. Infection can cause serious conditions, such as necrotizing fasciitis (the so-called flesh-eating bacteria) and toxic shock syndrome (TSS). Symptoms include:

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A persistent or recurrent high fever
Redness, pain, and swelling in the skin and the tissue beneath

Ear Infections. Some children experience ear infections from chickenpox. Hearing loss is a very rare result of this complication.

A middle ear infection is also known as otitis media. It is one of the most common of childhood infections. With this illness, the middle ear becomes red, swollen, and inflamed because of bacteria trapped in the eustachian tube.

Pneumonia. Pneumonia is suspected if coughing and abnormally rapid breathing develop in patients who have chickenpox. Adults and adolescents with chickenpox are at some risk for serious pneumonia. Pregnant women, smokers, and those with serious medical conditions are at higher risk for pneumonia if they have chickenpox. Oxygen and intravenous acyclovir are key treatments for this condition. Pneumonia that is caused by varicella can result in lung scarring, which may impair oxygen exchange over the following weeks, or even months.

Click the icon to see an image of pneumonia.

Neurological Complications.

Inflammation in the Brain. Encephalitis and meningitis, infection or inflammation in the central nervous systems, can occur in rare cases in both children and adults. This condition can be very dangerous, causing coma and even death.
Stroke. Although stroke in children is extremely rare, a condition called cerebral vasculitis, in which blood vessels in the brain become inflamed, has been associated with varicella-zoster. Varicella may be a factor in some cases of stroke in young adults.