Lower‐Limb Hypoplasia Due to Intrauterine Infection with Herpes Simplex Virus Type 2: Possible Confusion with Intrauterine Varicella‐Zoster Syndrome

Johansson, Anne Britt; Rassart, Anne; Blum, David; Beers, Danielle Van; Liesnard, Corinne

doi:10.1086/382673

Cited by 40 publications

(29 citation statements)

References 9 publications

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“…The alternative is to use amniocentesis to confirm ultrasonographic findings of anomalies, although it must be remembered that ultrasonography is not very sensitive or specific, and so it does not detect all malformations [169,498] . Some authors recommend following-up mothers who have contracted varicella during pregnancy by means of ultrasonography, and then searching for viral DNA in the case of malformations [19,159] , insisting on always searching for VZV DNA because other micro-organisms such as Coxsackie B and HSV can cause congenital lesions similar to those of CVS [502][503][504] . There is a report of a case of fetal malformations due to HSV2 and not VZV in a mother who contracted varicella during pregnancy [502] , and conditions such as microphthalmia dermal aplasia scleroderma (MIDAS) or microphthalmia with linear skin defects (MLS) may also lead to malformations, with maternal varicella being just a coincidence [505,506] .…”

Section: Prenatal Infection and The Diagnosis Of Cvsmentioning

confidence: 99%

“…Some authors recommend following-up mothers who have contracted varicella during pregnancy by means of ultrasonography, and then searching for viral DNA in the case of malformations [19,159] , insisting on always searching for VZV DNA because other micro-organisms such as Coxsackie B and HSV can cause congenital lesions similar to those of CVS [502][503][504] . There is a report of a case of fetal malformations due to HSV2 and not VZV in a mother who contracted varicella during pregnancy [502] , and conditions such as microphthalmia dermal aplasia scleroderma (MIDAS) or microphthalmia with linear skin defects (MLS) may also lead to malformations, with maternal varicella being just a coincidence [505,506] . There are few and unconvincing data concerning chorionic villi as the PCR-detected presence of viral DNA is not necessarily associated with an infected fetus, but may due to false positivity caused by maternal contamination or a placental infection not transmitted to the fetus [169,506,507] .…”

Section: Prenatal Infection and The Diagnosis Of Cvsmentioning

confidence: 99%

“…Molecular biology tests are also indicated in the case of rare or uncharacteristic malformations, or when the relationship between maternal infection and congenital malformations is doubtful [513] . Consideration should be given to differential diagnoses of congenital varicella with rubella, cytomegalovirus, HSV, Coxsackie virus, Toxoplasma gondii, and MIDAS or MLS [165,[502][503][504]514] .…”

Section: Diagnosis In Newbornsmentioning

confidence: 99%

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Microbiology laboratory and the management of mother-child varicella-zoster virus infection

Paschale

Clerici

2016

WJV

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Varicella-zoster virus, which is responsible for varicella (chickenpox) and herpes zoster (shingles), is ubiquitous and causes an acute infection among children, especially those aged less than six years. As 90% of adults have had varicella in childhood, it is unusual to encounter an infected pregnant woman but, if the disease does appear, it can lead to complications for both the mother and fetus or newborn. The major maternal complications include pneumonia, which can lead to death if not treated. If the virus passes to the fetus, congenital varicella syndrome, neonatal varicella (particularly serious if maternal rash appears in the days immediately before or after childbirth) or herpes zoster in the early years of life may occur depending on the time of infection. A Microbiology laboratory can help in the diagnosis and management of mother-child infection at four main times: (1) when a pregnant woman has been exposed to varicella or herpes zoster, a prompt search for specific antibodies can determine whether she is susceptible to, or protected against infection; (2) when a pregnant woman develops clinical symptoms consistent with varicella, the diagnosis is usually clinical, but a laboratory can be crucial if the symptoms are doubtful or otherwise unclear (atypical patterns in immunocompromised subjects, patients with post-vaccination varicella, or subjects who have received immunoglobulins), or if there is a need for a differential diagnosis between varicella and other types of dermatoses with vesicle formation; (3) when a prenatal diagnosis of uterine infection is required in order to detect cases of congenital varicella syndrome after the onset of varicella in the mother; and (4) when the baby is born and it is necessary to confirm a diagnosis of varicella (and its complications), make a differential diagnosis between varicella and other diseases with similar symptoms, or confirm a causal relationship between maternal varicella and malformations in a newborn. Core tip: Although varicella during pregnancy is infrequent and congenital varicella syndrome (CVS) is rare, every available means should be used to prevent and diagnose them. Microbiology laboratories can be crucial in these situations: Evaluating a mother's immune status with sensitive and specific tests for the detection of antibodies; allowing a rapid diagnosis with molecular biology tests when a clinical manifestation may be due to different etiologies; following pregnant women with varicella for the prenatal diagnosis of CVS with close collaboration between molecular biology investigators and specialists in imaging diagnostics.De Paschale M, Clerici P. Microbiology laboratory and the management of mother-child varicella-zoster virus infection. World

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Section: Prenatal Infection and The Diagnosis Of Cvsmentioning

confidence: 99%

Section: Prenatal Infection and The Diagnosis Of Cvsmentioning

confidence: 99%

Section: Diagnosis In Newbornsmentioning

confidence: 99%

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Microbiology laboratory and the management of mother-child varicella-zoster virus infection

Paschale

Clerici

2016

WJV

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“…To establish a relationship between maternal VZV infection and congenital anomalies of neonates, the criteria listed in Table 4 should be used as guideline. The differential diagnosis of CVS includes congenital infections caused by rubella virus, cytomegalovirus, herpes simplex virus (HSV), coxsackie virus or Toxoplasma gondii [23,34,35] and the specific genetic disorder called MIDAS (Microphthalmus, Dermal Aplasia, Sclerokornea) syndrome [36], whose cardinal symptoms represent congenital skin defects in dermatomal distribution associated with microphthalmia.…”

Section: Congenital Varicella Syndromementioning

confidence: 99%

Review of varicella-zoster virus infections in pregnant women and neonates

Sauerbrei¹

2010

Health

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Even though varicella is rare in pregnancy, the disease can lead occasionally to disastrous illnesses for both the mother and her neonate. By contrast, normal zoster is not associated with special problems during pregnancy and perinatal period. Pregnant women, who contract varicella, are at risk of varicella pneumonia which must be regarded as medical emergency. At any stage during pregnancy, chickenpox may cause intrauterine infection. The consequences for the fetus depend on the time of maternal disease. During the first two trimesters, maternal varicella may result in congenital varicella syndrome which may occur in nearly 2%. Typical symptoms are skin lesions in dermatomal distribution, neurological defects, eye diseases, and skeletal anomalies. Maternal infection near term is associated with a substantial risk of intrauterine acquired neonatal chickenpox in the neonate. If the mother develops varicella rash between day 4 (5) ante partum and day 2 post partum, generalized neonatal varicella leading to death in about 20% of the cases has to be expected. The present paper reviews the clinical consequences and the currently available concepts of prevention, diagnosis, and therapy of varicella-zoster virus infections during pregnancy.

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“…Defekte des zentralen Nervensystems und der Augen sind typisch für angeborene Röteln, Zytomegalie und Toxoplasmose [33]. Ähnliche Symptome wie beim FVS einschließlich Hautläsionen können auch nach primärer Herpes-simplex-Virus-(HSV-)Infektion in der Frühschwangerschaft beobachtet werden [34]. Eine intrauterine Coxsackievirus-Infektion während der Spätschwan-gerschaft kann zu Varizellen-ähnlichen Hautläsionen beim Kind führen [35].…”

Section: Diagnostik Des Fetalen Varizellensyndromsunclassified

Varizellen in der Schwangerschaft und bei Neugeborenen

Wutzler

Sauerbrei

2007

Bundesgesundheitsbl.

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Varicella belongs to the most common vaccine-preventable diseases in Germany. During pregnancy, varicella may have serious consequences for the pregnant women and for the fetus or newborn. Pregnant women who contract varicella are at risk of pneumonia which must be regarded as a medical emergency. Chicken pox between the 5th and 24th weeks of pregnancy may lead to the congenital varicella syndrome. In case of maternal varicella during the last few weeks of pregnancy or shortly after delivery, the virus can cause chicken pox in the newborn. Life-threaten ing disseminated neonatal varicella must be expected if the mother develops chicken pox between 5 days before and 2 days after delivery. Using currently available diagnostics, immuno-prophylactic and therapeutic opportunities, these serious consequences of varicella during pregnancy can be prevented.

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Lower‐Limb Hypoplasia Due to Intrauterine Infection with Herpes Simplex Virus Type 2: Possible Confusion with Intrauterine Varicella‐Zoster Syndrome

Cited by 40 publications

References 9 publications

Microbiology laboratory and the management of mother-child varicella-zoster virus infection

Microbiology laboratory and the management of mother-child varicella-zoster virus infection

Review of varicella-zoster virus infections in pregnant women and neonates

Varizellen in der Schwangerschaft und bei Neugeborenen

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