Primary varicella infection in children is generally a mild disease. The incidences of infection, hospitalizations, and mortality have all declined since the introduction of the varicella vaccine. Chickenpox is highly contagious, with secondary household attack rates of >90 percent in susceptible individuals. Transmission occurs in susceptible hosts via contact with aerosolized droplets from nasopharyngeal secretions of an infected individual or by direct cutaneous contact with vesicle fluid from skin lesions. Complications of varicella in children can include bacterial superinfection while pneumonia and cellulitis. Periorbital cellulitis arises most commonly from sinusitis or a contiguous infection of the soft tissues of the face and eyelids. The most common causes of periorbital cellulitis are Staphylococcus aureus (including community-acquired methicillin-resistant S. aureus [CA-MRSA]), Streptococcus pneumoniae and other streptococci, and anaerobes.
