Li Haiting, Chen Xiyang, Li Jie, Chen Linlin, Liu Xixi, Chen Caie, Xie Dengpan, Chen Yunqin, Yuan Junhui, Tao Enfu
Department of Neonatology and NICU, Wenling Maternal and Child Health Care Hospital, Wenling, Zhejiang, China.
Front Pediatr. 2024 Jul 19;12:1345338. doi: 10.3389/fped.2024.1345338. eCollection 2024.
Neonatal varicella is indeed a rare condition, and most infants born to mothers with varicella have a good prognosis. However, in exceptional cases, neonatal varicella can be life-threatening, particularly for preterm infants. Therefore, it is vital to make an early diagnosis or predict the risk of neonatal varicella to ensure prompt treatment and improve prognosis. This report made an effort to early predict neonatal vericalla by using metagenomic next-generation sequencing (mNGS) in a preterm infant who was at risk for vericalla infection. A preterm infant born from a mother with varicella with symptom onset at 8 days before delivery, putting the infant at risk for varicella infection. Importantly, the patient develop pneumonia and pneumothorax, and neonatal vericella was suspected. Fortunately, the use of mNGS for testing the varicella gene in the serum promptly ruled out varicella zoster virus (VZV) infection in the patient, as indicated by a negative mNGS result. Subsequent follow-up, which included a 14-day stay in the hospital followed by an additional 7 days at home, confirmed this finding. Throughout this period, the patient did not exhibit any rash or other symptoms associated with varicella. Therefore, the novel approach of using mNGS allows neonatologists to predict and promptly address potential neonatal infections. This early detection is crucial, as delayed diagnosis or treatment could pose life-threatening risks, as exemplified by the case of neonatal varicella. In such cases, neonatologists can take proactive measures instead of standing by for at-risk neonates. Furthermore, given the severity of neonatal varicella as a life-threatening condition, the early exclusion of subsequent varicella infection by mNGS can offer reassurance to both family members and healthcare professionals.
新生儿水痘确实是一种罕见病症，大多数水痘母亲所生的婴儿预后良好。然而，在特殊情况下，新生儿水痘可能危及生命，尤其是对早产儿而言。因此，早期诊断或预测新生儿水痘的风险对于确保及时治疗和改善预后至关重要。本报告致力于通过宏基因组下一代测序（mNGS）对一名有感染水痘风险的早产儿进行早期新生儿水痘预测。一名早产儿的母亲在分娩前8天出现水痘症状，这使该婴儿有感染水痘的风险。重要的是，该患者出现了肺炎和气胸，怀疑患有新生儿水痘。幸运的是，mNGS检测血清中的水痘基因结果为阴性，迅速排除了患者感染水痘带状疱疹病毒（VZV）。随后的随访，包括在医院住院14天，随后在家中再住7天，证实了这一结果。在此期间，患者未出现任何与水痘相关的皮疹或其他症状。因此，使用mNGS的新方法使新生儿科医生能够预测并及时处理潜在的新生儿感染。这种早期检测至关重要，因为延迟诊断或治疗可能带来危及生命的风险，新生儿水痘病例就是例证。在这种情况下，新生儿科医生可以采取积极措施，而不是对有风险的新生儿坐视不管。此外，鉴于新生儿水痘作为一种危及生命的疾病的严重性，通过mNGS早期排除后续水痘感染可以让家庭成员和医护人员都放心。
