Neonatal Varicella

Department of Pediatrics, NMCH; and *Hope Child Care and Research Center, Patna, Bihar, India.
 

A preterm SGA male baby presented with erythematous rash on face on day 6 of life. The rash assumed vesicular form on red base next day and spread over trunk and limbs (Fig. 1). Baby also had marked respiratory distress and convulsion. He was not maintaining saturation and required ventilatory support. Mother of the baby also had a similar eruption one day prior to delivery, which was clinically characteristic of varicella. Considering history and clinical presentation, a diagnosis of neonatal varicella was considered and the baby was put on acyclovir and supportive therapy to which he responded and recovered.

Fig. 1 Newborn with varicella rash.

Varicella in neonates presents as congenital or neonatal varicella. Congenital varicella occurs if mother gets infection in first trimester and the offspring presents with multiple anomalies. Neonatal varicella has two presentations. In a mother getting infection within 5 days before to 2 days after delivery, there is no time for transfer of varicella-associated antibody to the baby thus baby has severe infection. In second group mother has infection at least 5 days before delivery. Here adequate antibodies are transferred and the infection is less severe. Our case had severe infection as the mother presented with rash only one day prior to delivery. We are presenting this child to share the characteristic lesions.