Holistic and Comprehensive Management of Varicella in a Pediatric Patient Using a Family Medicine Approach in Primary Health Care: A Case Report

Abstract

Varicella is an acute and highly contagious viral infection caused by varicella-zoster virus. It commonly affects children and is characterized by fever, pruritus, and a generalized vesicular rash at different stages of development. Although many cases are self-limited, comprehensive management is important to reduce symptoms, prevent secondary skin infection, limit transmission, and strengthen family participation in care. This case report describes a 13-year-old boy who presented to a primary health care facility with small skin eruptions over the body accompanied by fever and generalized itching for five days. The patient had no history of allergy, no previous similar disease, and no family member with similar complaints. Physical examination showed stable general condition, pulse rate of 104 beats/minute, respiratory rate of 22 breaths/minute, body temperature of 36.6 °C, and underweight nutritional status with a body mass index of 16.3 kg/m². Dermatological examination revealed generalized papules and vesicles on an erythematous base involving the neck, thorax, upper limbs, abdomen, back, thighs, and lower legs. No laboratory or imaging investigation was performed. The patient was clinically diagnosed with varicella. Management included symptomatic therapy, acyclovir, topical acyclovir, antihistamine, cough medication, education to avoid scratching, nail trimming, hygiene improvement, adequate rest at home, and prevention of transmission. A family medicine assessment showed good family support but identified environmental density and hygiene as relevant contextual factors. This case highlights that primary care management of varicella should integrate clinical treatment, patient education, infection prevention, and family-centered support.