Managing Pus-Forming Chickenpox in Infants: A Guide for Parents

Varicella suppuration

If an 11-month-old child has chickenpox with pustules around the corners of the mouth, it is important to take the following steps:
1.
Keep the area clean: Gently clean the affected area with mild soap and water to prevent secondary bacterial infection.
2.
Avoid irritation: Ensure that the child does not scratch the pustules, as this can lead to further infection.
Keep the child's nails short and consider using mittens if necessary.
3.
Topical treatments: You may apply a topical antibiotic ointment as recommended by a healthcare provider to prevent infection.
4.
Pain relief:

Ms. Zhang, 20~29 year old female. Ask Date: 2007/07/13

Dr. He Shenglong reply Pediatrics

What you are referring to is likely a blister at the corner of the mouth, which subsequently becomes infected and pus-filled, correct? The appearance of a blister at the corner of the mouth, along with mild cold symptoms, suggests an infection by the herpes simplex virus, which is generally benign.
If there is pus, it may indicate a secondary bacterial infection, in which case oral antibiotics would be necessary.
Local treatment should follow standard aseptic procedures, such as cleaning with a cotton swab dipped in saline, disinfecting with povidone-iodine, or applying an anti-inflammatory ointment, although it is not recommended to apply these on the lips or inside the mouth.
If the blisters are caused by the varicella-zoster virus, the rash would be widespread, affecting the trunk, limbs, and face.
In such cases, if there is pus, oral antibiotics are crucial, and local treatment remains the same.
Thank you for your inquiry.

Reply Date: 2007/07/13

More Info

Managing chickenpox, especially when it presents with complications such as pus-forming lesions, can be concerning for parents. Chickenpox, caused by the varicella-zoster virus, typically manifests as an itchy rash that progresses from red spots to fluid-filled blisters and eventually crusts over. In infants, the immune system is still developing, making them more vulnerable to complications.

When an infant, such as your 11-month-old, develops chickenpox with pus-forming lesions, it is essential to take appropriate steps to manage the condition effectively and prevent further complications. Here are some guidelines for parents:
1. Consult a Pediatrician: The first step is to consult your child's pediatrician. They can assess the severity of the chickenpox and the extent of the infection. If the lesions are becoming infected (indicated by increased redness, warmth, swelling, or pus), medical intervention may be necessary.

2. Keep the Area Clean: Gently clean the affected area with mild soap and water. This helps to remove any crusts and reduces the risk of secondary bacterial infections. Pat the area dry with a clean towel, avoiding any vigorous rubbing that could irritate the skin further.

3. Avoid Scratching: It's crucial to prevent your child from scratching the lesions, as this can lead to further irritation and increase the risk of bacterial infection. Keeping your child's nails trimmed and using mittens or socks can help minimize scratching.

4. Topical Treatments: Your pediatrician may recommend topical treatments to soothe the skin and reduce itching. Calamine lotion is often used for chickenpox to alleviate itching. However, if there are signs of infection, your doctor may prescribe an antibiotic ointment to apply to the affected areas.

5. Monitor for Signs of Infection: Watch for signs that the lesions are becoming infected, such as increased redness, swelling, warmth, or pus. If you notice these symptoms, contact your pediatrician immediately, as oral antibiotics may be necessary.

6. Hydration and Nutrition: Ensure your child stays well-hydrated, especially if they are experiencing fever or discomfort. Offer plenty of fluids, and if your child is eating solids, provide nutritious foods that are easy to swallow.

7. Pain Management: If your child is experiencing discomfort, consult your pediatrician about appropriate pain relief options. Acetaminophen can be used to reduce fever and alleviate pain, but avoid giving aspirin to children due to the risk of Reye's syndrome.

8. Isolation: Chickenpox is highly contagious. Keep your child away from other children and individuals who have not had chickenpox or the vaccine until all lesions have crusted over.

9. Follow-Up Care: After the initial treatment, follow up with your pediatrician to ensure that the chickenpox is resolving appropriately and that there are no lingering complications.

In summary, managing chickenpox in infants, particularly with pus-forming lesions, requires careful attention and prompt medical advice. Keeping the affected area clean, preventing scratching, monitoring for signs of infection, and ensuring your child is comfortable are key steps in managing this condition. Always consult with your pediatrician for personalized advice and treatment options tailored to your child's specific needs.

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