What is the treatment for chickenpox in an 8-month-old child?

Treatment of Chickenpox in an 8-Month-Old Child

For an 8-month-old child with chickenpox, supportive care is the primary recommended treatment, as antiviral therapy is not routinely indicated in otherwise healthy infants with uncomplicated varicella infection. 1

Supportive Care Measures

• Maintain adequate hydration and nutrition to prevent dehydration during the febrile period 2
• Keep fingernails short and clean to minimize secondary bacterial infections from scratching 2
• Use gentle cleansing of skin lesions with mild soap and water to prevent secondary infections 2
• Dress the child in lightweight, loose-fitting clothing to minimize discomfort 2
• Control fever with acetaminophen as needed (avoid ibuprofen due to potential risk of severe skin infections) 2
• Apply calamine lotion or other soothing topical preparations to relieve itching 2

When to Consider Antiviral Therapy

Antiviral therapy with acyclovir is not routinely recommended for otherwise healthy infants with chickenpox, but should be considered in specific situations:

• If the infant has underlying chronic cutaneous or pulmonary disorders 3
• If the infant is immunocompromised or receiving immunosuppressive therapy 1
• If severe disease develops with complications 4, 5

Acyclovir Dosing (If Indicated)

If antiviral therapy is deemed necessary based on risk factors or disease severity:

• Oral acyclovir: 20 mg/kg per dose, 4 times daily (80 mg/kg/day) for 5 days 4
• Treatment should be initiated within the first 24 hours of rash onset for maximum effectiveness 5, 3

Special Considerations for Young Infants

• Chickenpox is typically milder in infants under 3 months of age due to maternal antibodies 6
• Complications are rare in newborns (10%) but increase with age: 42% at 1-2 months, 66% at 3-5 months, and 70-79% at 6-12 months 6
• At 8 months of age, maternal antibody protection has likely waned, potentially increasing risk of more severe disease 6

Warning Signs Requiring Medical Attention

Parents should seek immediate medical attention if the infant develops:

• High, persistent fever not responding to antipyretics 2
• Signs of dehydration (decreased urine output, dry mouth, lethargy) 2
• Severe skin lesions that appear red, warm, swollen, or contain pus 2
• Difficulty breathing or persistent cough 2
• Unusual drowsiness or difficulty waking 2
• Severe headache, stiff neck, or persistent vomiting 2

Prevention of Spread

• Keep the child isolated until all lesions have crusted over (typically 5-7 days) 1
• Family members who are susceptible to chickenpox and have been exposed may benefit from varicella vaccine if administered within 3-5 days of exposure 1
• For high-risk exposed individuals without immunity, varicella-zoster immune globulin (VZIG) may be indicated 1

Follow-up

• Most cases resolve without complications within 5-7 days 1
• Follow-up is typically not necessary unless complications develop 7
• Consider vaccination against varicella once the child reaches 12 months of age if they haven't already received it 1