Neonatal varicellaP35.8
Synonym(s)
neonatal varicella
DefinitionThis section has been translated automatically.
Mostly severe perinatal infection with varicella in first infected mothers. Critical time between the 7th day before and the 2nd day after birth.
PathogenThis section has been translated automatically.
Occurrence/EpidemiologyThis section has been translated automatically.
Incidence: 1-5/10,000 pregnancies.
EtiopathogenesisThis section has been translated automatically.
Infection of the child occurs diaplacentally as part of maternal viremia, by ascension of varicella zoster viruses via the birth canal or postnatally by aerogenic route.
ManifestationThis section has been translated automatically.
Occurring at or shortly after birth.
Clinical featuresThis section has been translated automatically.
Massive varicella exanthema with mostly hemorrhagic vesicles.
DiagnosisThis section has been translated automatically.
Medical history, clinic.
Complication(s)This section has been translated automatically.
Pneumonia (15% of patients), glomerulonephritis, meningoencephalitis, myelitis, hepatitis, purpura Schönlein-Henoch (leukocytoclastic vasculitis).
TherapyThis section has been translated automatically.
- Post-exposure: Therapy of the mother with varicella-zoster hyperimmunoglobulin (e.g. Varitect) before delivery. Mature newborns with maternal varicella less than 1 week before birth as well as all immature newborns with varicella also existing longer than 1 week, receive Varizella-Zoster-Immunoglobulin once 1 ml/kg bw i.v. Isolate the child from the mother immediately after birth. In case of already existing skin changes, the administration of hyperimmunoglobulin is pointless.
Remember! After administration of the specific immunoglobulin, a live vaccination (measles, mumps, rubella) is only weakly effective within the next 3 months.
- Disease: In case of a symptomatic newborn the immediate administration of Aciclovir (e.g. Zovirax) is indicated. Newborns: 10-20 mg/kg bw 3 times/day, infusion over 60 minutes, every 8 hours for 10-14 days. Cave! Extend intervals in case of renal insufficiency!
External therapyThis section has been translated automatically.
External blanket drying therapy with Lotio alba, if pyoderma persists, possibly addition of Clioquinol 0.5-2% or Clioquinol-containing cream (Linola-Sept). Alternatively synthetic tanning agents (e.g. Tannolact Lotio, Tannosynt).
ProphylaxisThis section has been translated automatically.
Varicella-zoster immunoglobulin (once only 0,2-1 ml/kg bw i.v.).
LiteratureThis section has been translated automatically.
- Gnann JW Jr (2002) Varicella-zoster virus: atypical presentations and unusual complications. J Infect Dis 186: S91-98
- Grospietsch G (2002) Varicella during pregnancy. German Med Weekly 127: 815-816
- Heimann R (1990) Varicella-zoster immunoglobulin for the protection of newborns. Drug therapy 8: 342
- Lipton SV et al (1989) Management of varicella exposure in a neonatal intensive care unit. JAMA 261: 1782-1784
- Mattson SN et al (2003) Neurodevelopmental follow-up of children of women infected with varicella during pregnancy: a prospective study. Pediatric Infect Dis J 22: 819-823
- Mazzella M et al (2003) Severe hydrocephalus associated with congenital varicella syndrome. CMAJ 168: 561-563
- Acid porridge A, angry P (2001) Neonatal varicella. J Perinatol 21: 545-549
- Stockhausen HB et al (1984) Risk of chickenpox in pregnancy and neonatal period. German Med Vschr 109: 1192-1196