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Nadkażenia bakteryjne, ropnie i płonica przyranna powikłaniami ospy wietrznej

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Ospa wietrzna to najczęstsza choroba zakaźna wśród dzieci. Mogą jednak zapaść na nią także osoby dorosłe. Objawia się charakterystyczną wysypką i świądem. Rozdrapywanie krost może doprowadzić do wtórnych nadkażeń i powstawania blizn.

Rozwój choroby jest skutkiem zakażenia wirusem ospy wietrznej i półpaśca (Varicella-zoster virus – VZV). Do zakażenia w największej liczbie przypadków dochodzi drogą kropelkową. Ospą wietrzną można również zarazić się przez kontakt z treścią zmian skórnych występujących u chorej osoby.

Jakie są objawy ospy wietrznej?

Pierwszymi objawami zakażenia wirusem ospy wietrznej są gorączka, ból głowy i mięśni, nieżyt nosa i obniżenie nastroju. W niektórych przypadkach występują także objawy takie jak zaczerwienienie skóry i bóle brzucha, a nawet biegunka.

Po upływie około dwóch dni pojawia się wysypka. Mogą wystąpić na całym ciele. Rzadko pojawiają się jednak na stopach i dłoniach. U niektórych chorych obejmują także błony śluzowe jamy ustnej i gardła oraz narządów płciowych. Na początku wysypka przyjmuje postać rumieniowatych plamek, następnie grudek, na powierzchni których powstają pęcherzyki. Pęcherzyki początkowo wypełnione są przejrzystym, a później mętnym płynem. Następnie przyjmują postać krost, które zasychają i odpadają.

Wykwity skórne powodują uciążliwy świąd. Rozdrapywanie swędzących zmian może skutkować powstaniem trwałych blizn.

 

Jakie mogą być powikłania ospy wietrznej?

Rozdrapywanie wykwitów może doprowadzić do wtórnych nadkażeń bakteryjnych, zwykle wywołanych przez paciorkowca ropnego i gronkowca złocistego. W wielu przypadkach dochodzi do rozwoju ropni, ropowicy czy płonicy przyrannej. Infekcje paciorkowcowe mogą doprowadzić do martwiczego zapalenia powięzi i sepsy.

Kto jest narażony na powikłania ospy wietrznej?

Na powikłania ospy wietrznej szczególnie narażone są osoby z obniżoną odpornością, które przeszły chemioterapię lub radioterapię, pacjenci przyjmujący leki immunosupresyjne i kwas acetylosalicylowy oraz chorzy na m.in. AIDS czy białaczkę.

Ryzyko wtórnych zakażeń bakteryjnych zwiększa również przyjmowanie niesteroidowych leków przeciwzapalnych.

Jednym z częstych powikłań ospy są zakażenia zmian skórnych występujących w przebiegu chorób dermatologicznych, np. egzemy czy atopowego zapalenia skóry.

Dzieci poniżej 12 roku życia zazwyczaj przechodzą ospę łagodniej niż osoby dorosłe. Cięższy przebieg ospy odnotowuje się natomiast u noworodków, zwłaszcza wcześniaków. Powikłania często występują też u kobiet w ciąży ze względu na osłabienie układu immunologicznego.

Jak leczyć ospę wietrzną?

Chorzy na ospę powinni ograniczyć kontakt z osobami zdrowymi ze względu na wysoką zaraźliwość choroby.

W przypadku łagodnego przebiegu ospy wietrznej wdraża się leczenie objawowe skierowane na obniżenie temperatury i zmniejszenie świądu. W tym celu stosuje się leki przeciwhistaminowe, miejscowe preparaty o działaniu osuszającym i przeciwświądowym. Nie powinno się stosować pudrów, ponieważ mogą przyczynić się do rozwoju wtórnych zakażeń bakteryjnych.

Pacjentom zaleca się także codzienną kąpiel, która nie powinna być jednak zbyt długa. Nadmierne rozmoczenie skóry wydłuża czas gojenia. Podczas osuszania skóry należy zachować szczególną ostrożność, by nie naruszyć krost.

Jeśli wskutek naruszenia wykwitów doszło do zakażenia, lekarz może wdrożyć antybiotykoterapię.

W przypadku ciężkiej postaci choroby lub u osób szczególnie narażonych na powikłania lekarz może zalecić lek przeciwwirusowy – acyklowir. Środek ten hamuje namnażanie wirusa i ogranicza rozprzestrzenianie się wykwitów, a także łagodzi objawy i skraca przebieg choroby.

Źródło: mp.pl

 

Przeczytaj także: Jak rozpoznać zmiany skórne przy półpaścu?

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