Cook Brenna, Shadowen Caroline, Clark Lorna, Hoover Alena, Lee Stephanie, Bender Whitney
School of Medicine, Virginia Commonwealth University, Richmond, VA, USA.
Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA, USA.
Case Rep Infect Dis. 2024 Apr 12;2024:1937661. doi: 10.1155/2024/1937661. eCollection 2024.
Herpes simplex (HSV) and varicella zoster (VZV) viruses are harmful infectious agents in pregnancy due to their ability to impact maternal-fetal dyads through various modalities including vertical transmission, neonatal infection, and maternal morbidity. As a result, accurate diagnosis and prompt treatment of these infections in pregnancy is critical.
A 19-year-old primigravida presented to our tertiary care center at 30 weeks' gestation with vulvar swelling, burning, and pain. Workup included direct PCR testing of a particularly erythematous area of the vulva which returned positive for VZV. The patient was treated with a 10-day course of acyclovir with resolution of her symptoms. She later had a full-term spontaneous vaginal delivery outside of the infectious window with no significant morbidity for either her or her neonate.
Although a rare presentation, the presence of a genital lesion or labial swelling during pregnancy warrants workup for VZV, particularly among patients known to be varicella nonimmune. If genital VZV is diagnosed during pregnancy, the development of contingency plans through interdisciplinary collaboration should be pursued to ensure a safe delivery and postpartum course for both the maternal-fetal dyad as well as other patients on the unit and the provider care team.
单纯疱疹病毒（HSV）和水痘带状疱疹病毒（VZV）是孕期有害的感染因子，因为它们能够通过垂直传播、新生儿感染和母体发病等多种方式影响母婴二元组。因此，孕期对这些感染进行准确诊断和及时治疗至关重要。
一名19岁初产妇在妊娠30周时因外阴肿胀、灼痛和疼痛就诊于我们的三级医疗中心。检查包括对外阴一个特别红斑区域进行直接PCR检测，结果显示VZV呈阳性。患者接受了为期10天的阿昔洛韦治疗，症状得到缓解。她后来在感染窗口期之外足月自然阴道分娩，她和她的新生儿均无明显发病情况。
尽管表现罕见，但孕期出现生殖器病变或唇部肿胀时，有必要对VZV进行检查，尤其是在已知对水痘无免疫力的患者中。如果在孕期诊断出生殖器VZV感染，应通过跨学科协作制定应急计划，以确保母婴二元组以及病房其他患者和医护团队都能有一个安全的分娩和产后过程。
