By Tedler D. Depaynos, MD
The 32 year old male patient had been having a “low grade fever and slight body malaise”. Because his uncomfortable feeling was still tolerable, he continued reporting for work which required a lot of physical exertion. It was after 3 or 4 days when he started complaining of reddish skin lesions which were both “itchy and a little painful”. Eventually they spread all over his body filled with clear fluid at the tip but some appeared pus-like. When his co-workers saw the lesions they immediately diagnosed it as “chicken pox” and immediately avoided him and asked him to go on leave. When he mentioned that his wife and 2 children and also a neighbor have similar lesions, the more he was asked to go on leave and all his co-workers especially his teammates threatened not to bring him along to their place of work if he will not.
Obviously, most of his co-workers had seen or experienced the so called “chicken pox”. He consulted the MD his family is familiar with but unfortunately the MD admitted that it was quite some time which is more than a decade ago since he had seen a classical one because he limited his practice to his Surgical Specialty. He then accompanied his adult patient to a nearby young and tall pediatrician to whom he showed his lesions because pediatricians are expected to be familiar with this disease which infect mostly the young. The young pediatrician smiled as she noted the MD’s poor experience when she confirmed the diagnosis of the lesions. The MD was very grateful, however, when his smiling colleague gave a short but very informative lecture.
“Chicken pox” is due to Varicella Virus which causes also the so called “shingles” or Herpez Zoster. It is usually spread thru the respiratory system especially in children and thru the liquid portion of the lesions called “vesicles” or “pustules” which contain the virus. The disease is very communicable. The complaints of the patient are the classical manifestations of the disease. Since it is due to a virus it is supposed to be self-limiting and medications prescribed are just for the pain and fever.
In some cases complications may occur like respiratory infections or infection of the lesions so that in selected cases, antibiotics may be prescribed to prevent the infection. In some sensitive patients who complain of severe pain and body malaise, an anti- viral drug may sometimes be prescribed like Ancyclovir. The lecturing pediatrician however emphasized that the medicine may lessen the pain and just shorten the course of the disease. In an analogy, she mentioned that instead of the disease lasting for 7 to10 days, the medicine would make it last for 5 to 8 days only.
When the MD asked the pediatrician why it was called “chicken pox” implying in a joking manner that perhaps the virus came from chickens, the pediatrician lost her smile and promised to research but immediately dismissed the MD trying to hide her irritation. The MD nevertheless was thankful for the short review.
Since the patient appeared to be taking his complaints easy, no medications were prescribed but a medical certificate was issued to justify his absence from his work. It was actually the purpose why he consulted the MD he is familiar with. He was advised however to keep the lesions clean and to bring his children to the consulted pediatrician if their feelings worsen or have other complains like persistent coughing and fever.
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