Antihistamines may provide relief of pruritus. Complications of varicella may be treated with oral or intravenous and appropriate supportive therapy. Primary varicella is often a benign, self-limited illness. However, complications occur in some cases, with increasing morbidity and mortality with increasing age of the patient. These include bacterial superinfection, hemorrhagic varicella, varicella pneumonia, encephalitis, varicella hepatitis, thrombocytopenic purpura, and Reye's Syndrome.
Bacterial superinfection is the most common complication of varicella.
Most cases respond well to oral antibiotic therapy, with the most common pathogens being Staphylococcus aureus and Streptococcus pyogenes. Hemorrhagic varicella is a very extensive eruption of hemorrhagic vesicles associated with primary varicella infection. This may be accompanied by a bleeding diathesis, high fever and severe constitutional symptoms. Hemorrhagic varicella is more common in areas where malnutrition is common, and in the United States is most frequently seen in immunocompromised patients. Smoking represents an important risk factor, and pregnant patients may be at even higher risk.