infectious disease/chicken pox

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686463876c78b8d82816dd23

Pediatrics

infectious disease

chicken pox

A 45-year-old man, who underwent a liver transplant two years prior and is currently maintained on tacrolimus, mycophenolate mofetil, and prednisone, presents to an outpatient transplant clinic. He reports developing a low-grade fever (37.80C), generalized malaise, and mild myalgia over the past 24 hours. He recalls that approximately 9 days ago, he had attended a family gathering where he was in close contact with a young child who later developed a widespread vesicular rash diagnosed as chickenpox by their pediatrician. The patient denies any prior history of chickenpox or vaccination. On physical examination, his temperature is 37.90C, blood pressure is 118/76 mmHg, pulse is 88/min, and respirations are 18/min. Examination of his skin reveals a few scattered, erythematous macules and papules, predominantly on his trunk and face, with one or two already developing into clear vesicles. There are no signs of secondary bacterial infection. What is the most appropriate diagnostic approach and immediate management strategy, considering his immunocompromised status?

Lab ParameterValueReference Range
White Blood Cell Count6.5 x 10^9/L4.0-10.0 x 10^9/L
Lymphocytes0.8 x 10^9/L1.0-4.0 x 10^9/L
C-reactive Protein (CRP)25 mg/L<5 mg/L
VZV IgG AntibodiesNegativeNegative

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