Suryaningrat Filla Reviyani, Irenewati Sindy, Hudayari Devatri, Kadi Fiva Aprilia, Primadi Aris, Yuniati Tetty
Department of Child Health, Faculty of Medicine, Universitas Padjajaran, Dr Hasan Sadikin General Hospital, Bandung 40161, West Java, Indonesia.
Faculty of Medicine, Universitas Diponegoro, Semarang 50244, Central Java, Indonesia.
Children (Basel). 2025 Aug 18;12(8):1081. doi: 10.3390/children12081081.
Chicken pox is a rare but serious condition in neonates-often regarded as a common childhood illness with mild symptoms-yet it can lead to severe complications, especially in the perinatal period. Neonatal varicella may present with fever occurring within the first 5-10 days of life, followed by a generalized vesicular eruption. The syndrome is uncommon, largely due to the widespread immunity in women of childbearing age, acquired through prior chicken pox infection or varicella immunization. However in Indonesia, a developing country without a national mandatory varicella vaccination program, the disease burden remains significant, and cases of neonatal varicella are still encountered. Neonates are at high risk of severe varicella infection, which, if untreated, has a reported mortality rate of up to 30%. Although varicella is rare in neonates, there are limited studies that have reported it. This study highlights the clinical presentations upon admission, diagnostic investigations, therapeutic management strategies, and potential complications of neonatal varicella. This study presents two cases of neonatal varicella that were managed at Hasan Sadikin General Hospital in West Java, Indonesia. Each patient underwent a clinical assessment and diagnostic evaluation upon arrival, followed by therapeutic management strategies, including the management of any complications that emerged during treatment. The two cases of neonates presented with classic clinical features of neonatal varicella, including a generalized vesicular rash followed by fever within the first 10 to 12 days of life, without dermatological lesions or congenital malformations at birth. In both cases, maternal chicken pox developed within the first few days postpartum, suggesting postnatal transmission as the likely source of infection. Complications observed included respiratory failure and pneumonia, requiring respiratory support. However, both neonates recovered successfully without the administration of IVIG. Early initiation of antiviral therapy, timely administration of antibiotics, comprehensive supportive care, and monitoring for potential complications play a crucial role in managing neonatal varicella, even in the absence of IVIG.
水痘在新生儿中是一种罕见但严重的疾病——通常被视为一种症状轻微的常见儿童疾病——然而它可能导致严重并发症，尤其是在围产期。新生儿水痘可能在出生后的头5至10天内出现发热，随后出现全身性水疱疹。该综合征并不常见，主要是由于育龄妇女通过既往水痘感染或水痘免疫获得了广泛的免疫力。然而在印度尼西亚，这个没有全国性强制性水痘疫苗接种计划的发展中国家，疾病负担仍然很重，新生儿水痘病例仍有出现。新生儿有发生严重水痘感染的高风险，据报道，如果不治疗，死亡率高达30%。虽然水痘在新生儿中很少见，但报道它的研究有限。本研究强调了新生儿水痘入院时的临床表现、诊断检查、治疗管理策略以及潜在并发症。 本研究介绍了在印度尼西亚西爪哇的哈桑·萨迪金综合医院治疗的两例新生儿水痘病例。每位患者入院时都接受了临床评估和诊断评估，随后采取了治疗管理策略，包括处理治疗期间出现的任何并发症。 这两例新生儿表现出新生儿水痘的典型临床特征，包括全身性水疱疹，随后在出生后的头10至12天内发热，出生时无皮肤病变或先天性畸形。在这两例病例中，母亲的水痘在产后头几天出现，提示产后传播可能是感染源。观察到的并发症包括呼吸衰竭和肺炎，需要呼吸支持。然而，两名新生儿在未使用静脉注射免疫球蛋白的情况下均成功康复。 即使在没有静脉注射免疫球蛋白的情况下，早期开始抗病毒治疗、及时使用抗生素、全面的支持性护理以及监测潜在并发症在管理新生儿水痘方面也起着至关重要的作用。
