Treatment of primary varicella with oral acyclovir is thought by some to decrease the number of skin lesions and to shorten the duration of the illness, particularly in adults. Treatment of primary varicella may also decrease the incidence of complications. Therapy should also include acetaminophen for control of fever, myalgias, or headaches that may accompany primary infections. 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.