Varicella

Varicella Exposure and Chemo
 

Congenital Varicella Syndrome / Neonatal Chicken Pox

Epidemiology: 2% of fetuses whose mothers developed chicken pox between 8 and 20 weeks (2 to 5 mos gestation) (6-12 weeks has maximal defects)

Presentation:

• General: symmetric IUGR
• CNS: Microcephaly, calcifications, cortical atrophy
• Extremities: Limb hypoplasia
• Skin: Characteristic extremity scarring

Neonatal Chicken Pox

• Perinatal Infection 5 days before to 2 days after delivery leads to severe infant infection
• VZIG recommended and leads to milder disease
• VZIG for all preemies exposed to varicella even greater than one week
• Greater than 1 week before delivery leads to mild or no neonatal infection
• Perinatally acquired varicella merits Acyclovir treatment (10 mg/kg q8h)

CHLA Board Review 2005