Dr. Gauri Chauhan,
B 24, Mullana, Ambala-133207, Haryana, India.
Neonatal Varicella is an uncommon disease in the Indian population, due to the presence of antibodies in the mother formed on the exposure to illness in their teenage in majority of population. The acquired varicella in newborn period, born to a non-immune mother shows a disseminated disease pattern with poor prognosis and high risk of mortality due to pneumonia, hepatitis, coagulopathy and secondary severe sepsis. The definite diagnosis is made by virus isolation or amplification of viral DNA from the skin lesions by PCR, but the clinical diagnosis from the pattern of rash hints the diagnosis well and appropriate. The drug of choice is intravenous acyclovir and Varicella Zoster Immune Globulin (VZIG), although the use of VZIG still remains debatable in symptomatic individuals.
Here, we present a case of a 15-day-old newborn with confluent maculo-papular rash preceded by rash in the mother at 10th day post-delivery. The newborn was managed in NICU with standard protocols, but the prognosis became poor due to complications that were pneumonia, hepatitis and secondary sepsis.