Foetal Varicella Syndrome

Abstract

Foetal varicella syndrome (FVS) is a foetopathy caused by the Varicella-Zoster virus (HVZ) and is characterised by dermatomal skin lesions, limb hypoplasia, and damage to the eye and central nervous system. FVS is suspected in a pregnant woman, with less than 25 weeks of gestation, infected with HVZ and a neonate with clinical symptoms. FVS can be confirmed by detection of HVZ in the amniotic fluid, serological testing of the newborn and or the presence of HVZ in early childhood. Fetal damage can be attenuated or prevented using antiviral drugs, immunoglobulin or varicella vaccine.

Case report: A term neonate was born to a mother affected by chicken-pox during the third month of pregnancy. He had a facial scar with hipoplastic skin surrounding it and bilateral cataracts. IgG anti-varicella was positive for both mother and child, TORCH studies were negative. Cerebral CT was normal, but the right petrous bone was hypoplastic. The child suffered repeated bronchopneumonias with posterior control lung damage, had severe gastro-esophageal reflux, with suction-deglution dysfunction and neurological damage. The child died from necrotizing enterocolitis and multisystem failure at 7 months.

Comments: FVS is a less well known complication of HVZ with poor management by perinatal teams. HVZ produces other severe paediatric complications and for these reasons we recommend the inclusion of the varicella vaccine in the Chilean immunization programme.