Varicela congénita
Congenital varicella syndrome
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González Pabón, D., Ramírez Barrera, M. I., & Tovar Velásquez, M. J. (2023). Varicela congénita . Revista Repertorio De Medicina Y Cirugía, 32(1), 86–91. https://doi.org/10.31260/RepertMedCir.01217372.968
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Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.
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La infección por virus de varicela zóster (VVZ) durante el embarazo se engloba en el espectro de infecciones STORCH (acrónimo de sífilis, toxoplasmosis, otros, rubéola, citomegalovirus y herpes virus), debido a su potencial teratogénico y sus posibles repercusiones en el bienestar fetal. A pesar de que solo 2% de las pacientes con infección por VVZ en el embarazo tendrán fetos con síndrome congénito de varicela, su alta morbimortalidad hace necesario conocer posibles formas de prevención. En nuestro caso, una madre de 27 años da a luz un neonato con múltiples malformaciones óseas y lesiones cutáneas típicas, asociadas con malformaciones cardiacas y calcificaciones viscerales evidenciadas por imagenología. Ante la comprobación clínica y paraclínica de la infección, se diagnosticó síndrome congénito de varicela. El paciente presentó una evolución tórpida desde el nacimiento, con neumonía multirresistente, enterocolitis necrotizante y rápido deterioro de su patrón respiratorio con posterior fallecimiento. En la actualidad la vacunación y el uso de inmunoglobulina posexposición son los principales aliados para la prevención de este síndrome en recién nacidos.
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Referencias
1. Sanchez MA, Bello-Munoz JC, Cebrecos I, Sanz TH, Martinez JS, Moratonas EC, et al. The prevalence of congenital varicella syndrome after a maternal infection, but before 20 weeks of pregnancy: a prospective cohort study. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstet. 2011;24(2):341-7. Epub 2010/07/31.
2. Levin MJ, Weinberg A, Schmid DS. Herpes Simplex Virus and Varicella-Zoster Virus. Microbiology spectrum. 2016;4(3). Epub 2016/06/24.
3. Dayan RR, Peleg R. Herpes zoster - typical and atypical presentations. Postgraduate medicine. 2017;129(6):567-71. Epub 2017/05/26.
4. Kawai K, Yawn BP. Risk Factors for Herpes Zoster: A Systematic Review and Meta-analysis. Mayo Clinic proceedings. 2017;92(12):1806-21. Epub 2017/12/06.
5. Neu N, Duchon J, Zachariah P. TORCH infections. Clinics in perinatology. 2015;42(1):77-103, viii. Epub 2015/02/14.
6. Cohen A, Moschopoulos P, Stiehm RE, Koren G. Congenital varicella syndrome: the evidence for secondary prevention with varicella-zoster immune globulin. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne. 2011;183(2):204-8. Epub 2011/01/26.
7. Enders G, Miller E, Cradock-Watson J, Bolley I, Ridehalgh M. Consequences of varicella and herpes zoster in pregnancy: prospective study of 1739 cases. Lancet. 1994;343(8912):1548-51. Epub 1994/06/18.
8. Tongsong T, Srisupundit K, Traisrisilp K. Prenatal sonographic diagnosis of congenital varicella syndrome. Journal of clinical ultrasound : JCU. 2012;40(3):176-8. Epub 2012/02/11.
9. Auriti C, Piersigilli F, De Gasperis MR, Seganti G. Congenital varicella syndrome: still a problem? Fetal diagnosis and therapy. 2009;25(2):224-9. Epub 2009/05/30.
10. Lamont RF, Sobel JD, Carrington D, Mazaki-Tovi S, Kusanovic JP, Vaisbuch E, et al. Varicella-zoster virus (chickenpox) infection in pregnancy. BJOG : an international journal of obstetrics and gynaecology. 2011;118(10):1155-62. Epub 2011/05/19.
11. Benoit G, Etchemendigaray C, Nguyen-Xuan HT, Vauloup-Fellous C, Ayoubi JM, Picone O. Management of varicella-zoster virus primary infection during pregnancy: A national survey of practice. Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology. 2015;72:4-10. Epub 2015/09/12.
12. Bialas KM, Swamy GK, Permar SR. Perinatal cytomegalovirus and varicella zoster virus infections: epidemiology, prevention, and treatment. Clinics in perinatology. 2015;42(1):61-75, viii. Epub 2015/02/14.
13. Harger JH, Ernest JM, Thurnau GR, Moawad A, Momirova V, Landon MB, et al. Risk factors and outcome of varicella-zoster virus pneumonia in pregnant women. The Journal of infectious diseases. 2002;185(4):422-7. Epub 2002/02/28.
14. Gnann JW, Jr. Varicella-zoster virus: Prevention through vaccination. Clinical obstetrics and gynecology. 2012;55(2):560-70. Epub 2012/04/19.
15. Advisory Committee on Immunization Practices. Recommended adult immunization schedule: United States, 2012. Annals of internal medicine. 2012;156(3):211-7. Epub 2012/02/03.
16. Bardach A, Cafferata ML, Klein K, Cormick G, Gibbons L, Ruvinsky S. Incidence and use of resources for chickenpox and herpes zoster in Latin America and the Caribbean--a systematic review and meta-analysis. The Pediatric infectious disease journal. 2012;31(12):1263-8. Epub 2012/11/29.
17. Ahn KH, Park YJ, Hong SC, Lee EH, Lee JS, Oh MJ, et al. Congenital varicella syndrome: A systematic review. Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology. 2016;36(5):563-6. Epub 2016/03/12.
18. Mehta S, Schenk W, Kirker S, Atrey A. Isolated lower limb hypoplasia secondary to congenital varicella syndrome: a rare occurrence and management of its complications. BMJ case reports. 2017;2017. Epub 2017/03/24.
19. Rodriguez-Fanjul X, Noguera A, Vicente A, Gonzalez-Ensenat MA, Jimenez R, Fortuny C. Herpes zoster in healthy infants and toddlers after perinatal exposure to varicella-zoster virus: a case series and review of the literature. The Pediatric infectious disease journal. 2010;29(6):574-6. Epub 2010/06/03.
20. Deguchi E, Imafuku S, Nakayama J. A case of infantile herpes zoster in an infant born to a mother infected with varicella at 7 weeks of pregnancy. The Journal of dermatology. 2011;38(6):622-4. Epub 2011/03/01.
21. West SL, Newton RW, Baildam EM, Turner AJ, Arkwright PD. Recurrent hemiplegia associated with cerebral vasculopathy following third trimester maternal herpes zoster infection. Developmental medicine and child neurology. 2006;48(12):991-3. Epub 2006/11/18.
22. Swamy GK, Heine RP. Vaccinations for pregnant women. Obstetrics and gynecology. 2015;125(1):212-26. Epub 2015/01/07.
2. Levin MJ, Weinberg A, Schmid DS. Herpes Simplex Virus and Varicella-Zoster Virus. Microbiology spectrum. 2016;4(3). Epub 2016/06/24.
3. Dayan RR, Peleg R. Herpes zoster - typical and atypical presentations. Postgraduate medicine. 2017;129(6):567-71. Epub 2017/05/26.
4. Kawai K, Yawn BP. Risk Factors for Herpes Zoster: A Systematic Review and Meta-analysis. Mayo Clinic proceedings. 2017;92(12):1806-21. Epub 2017/12/06.
5. Neu N, Duchon J, Zachariah P. TORCH infections. Clinics in perinatology. 2015;42(1):77-103, viii. Epub 2015/02/14.
6. Cohen A, Moschopoulos P, Stiehm RE, Koren G. Congenital varicella syndrome: the evidence for secondary prevention with varicella-zoster immune globulin. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne. 2011;183(2):204-8. Epub 2011/01/26.
7. Enders G, Miller E, Cradock-Watson J, Bolley I, Ridehalgh M. Consequences of varicella and herpes zoster in pregnancy: prospective study of 1739 cases. Lancet. 1994;343(8912):1548-51. Epub 1994/06/18.
8. Tongsong T, Srisupundit K, Traisrisilp K. Prenatal sonographic diagnosis of congenital varicella syndrome. Journal of clinical ultrasound : JCU. 2012;40(3):176-8. Epub 2012/02/11.
9. Auriti C, Piersigilli F, De Gasperis MR, Seganti G. Congenital varicella syndrome: still a problem? Fetal diagnosis and therapy. 2009;25(2):224-9. Epub 2009/05/30.
10. Lamont RF, Sobel JD, Carrington D, Mazaki-Tovi S, Kusanovic JP, Vaisbuch E, et al. Varicella-zoster virus (chickenpox) infection in pregnancy. BJOG : an international journal of obstetrics and gynaecology. 2011;118(10):1155-62. Epub 2011/05/19.
11. Benoit G, Etchemendigaray C, Nguyen-Xuan HT, Vauloup-Fellous C, Ayoubi JM, Picone O. Management of varicella-zoster virus primary infection during pregnancy: A national survey of practice. Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology. 2015;72:4-10. Epub 2015/09/12.
12. Bialas KM, Swamy GK, Permar SR. Perinatal cytomegalovirus and varicella zoster virus infections: epidemiology, prevention, and treatment. Clinics in perinatology. 2015;42(1):61-75, viii. Epub 2015/02/14.
13. Harger JH, Ernest JM, Thurnau GR, Moawad A, Momirova V, Landon MB, et al. Risk factors and outcome of varicella-zoster virus pneumonia in pregnant women. The Journal of infectious diseases. 2002;185(4):422-7. Epub 2002/02/28.
14. Gnann JW, Jr. Varicella-zoster virus: Prevention through vaccination. Clinical obstetrics and gynecology. 2012;55(2):560-70. Epub 2012/04/19.
15. Advisory Committee on Immunization Practices. Recommended adult immunization schedule: United States, 2012. Annals of internal medicine. 2012;156(3):211-7. Epub 2012/02/03.
16. Bardach A, Cafferata ML, Klein K, Cormick G, Gibbons L, Ruvinsky S. Incidence and use of resources for chickenpox and herpes zoster in Latin America and the Caribbean--a systematic review and meta-analysis. The Pediatric infectious disease journal. 2012;31(12):1263-8. Epub 2012/11/29.
17. Ahn KH, Park YJ, Hong SC, Lee EH, Lee JS, Oh MJ, et al. Congenital varicella syndrome: A systematic review. Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology. 2016;36(5):563-6. Epub 2016/03/12.
18. Mehta S, Schenk W, Kirker S, Atrey A. Isolated lower limb hypoplasia secondary to congenital varicella syndrome: a rare occurrence and management of its complications. BMJ case reports. 2017;2017. Epub 2017/03/24.
19. Rodriguez-Fanjul X, Noguera A, Vicente A, Gonzalez-Ensenat MA, Jimenez R, Fortuny C. Herpes zoster in healthy infants and toddlers after perinatal exposure to varicella-zoster virus: a case series and review of the literature. The Pediatric infectious disease journal. 2010;29(6):574-6. Epub 2010/06/03.
20. Deguchi E, Imafuku S, Nakayama J. A case of infantile herpes zoster in an infant born to a mother infected with varicella at 7 weeks of pregnancy. The Journal of dermatology. 2011;38(6):622-4. Epub 2011/03/01.
21. West SL, Newton RW, Baildam EM, Turner AJ, Arkwright PD. Recurrent hemiplegia associated with cerebral vasculopathy following third trimester maternal herpes zoster infection. Developmental medicine and child neurology. 2006;48(12):991-3. Epub 2006/11/18.
22. Swamy GK, Heine RP. Vaccinations for pregnant women. Obstetrics and gynecology. 2015;125(1):212-26. Epub 2015/01/07.
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