RESUMEN
We report a preterm neonate born with respiratory distress. The neonate was found to have diaphragmatic palsy and brachial palsy. The neonate was born by caesarean section and there was no history of birth trauma. On examination, there was bilateral congenital talipes equinovarus and a scar was present on the forearm. The mother had a history of chickenpox during the 16 weeks of pregnancy for which no treatment was sought. On investigation, PCR for varicella was found to be positive in the neonate.
Asunto(s)
Neuropatías del Plexo Braquial/virología , Varicela/congénito , Pie Equinovaro/virología , Enfermedades Fetales/virología , Antebrazo/anomalías , Complicaciones Infecciosas del Embarazo/virología , Parálisis Respiratoria/virología , Aciclovir/uso terapéutico , Antibacterianos/uso terapéutico , Neuropatías del Plexo Braquial/fisiopatología , Neuropatías del Plexo Braquial/terapia , Moldes Quirúrgicos , Cesárea , Varicela/transmisión , Pie Equinovaro/terapia , Femenino , Enfermedades Fetales/fisiopatología , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Masculino , Madres , Embarazo , Complicaciones Infecciosas del Embarazo/fisiopatología , Parálisis Respiratoria/fisiopatología , Parálisis Respiratoria/terapia , Resultado del TratamientoRESUMEN
Isolated lower limb hypoplasia is a rare consequence of maternal congenital varicella syndrome (CVS). The hypoplastic limb is susceptible to multiple injuries, including fractures, especially if there is associated muscle weakness and lack of sensation. We describe a unique index case of a woman aged 26 years with a background of CVS who presented with a distal femur fracture following a fall onto her insensate, hypoplastic right leg. This report highlights the complexities involved in the diagnosis and management of fractures in patients with an anaesthetic limb, and in particular describes limb amputation as a successful treatment modality for distal femur fractures.
Asunto(s)
Varicela/complicaciones , Fracturas del Fémur/cirugía , Hipoestesia/etiología , Pierna/anomalías , Adulto , Amputación Quirúrgica , Varicela/congénito , Femenino , Fracturas del Fémur/congénito , Humanos , Hipoestesia/cirugía , Pierna/anatomía & histología , Traumatismos de la Pierna/complicaciones , Traumatismos de la Pierna/cirugía , SíndromeRESUMEN
A wide array of infectious diseases can occur in pregnancy. Their acquisition, clinical presentation, and course during gestation may be altered due to an impairment of the maternal cellular immunity. Some infectious diseases can lead to serious consequences for the mother or the offspring, including congenital malformations. This review describes in detail the clinical presentation, course, management, and associated maternal and fetal risks of selected viral (varicella-zoster virus infections, condylomata acuminata), fungal (candida vulvovaginitis), bacterial (Lyme borreliosis), and parasitic (scabies) infections. The treatment options are critically reviewed. First-line therapies include acyclovir and varicella-zoster virus immunoglobulin for varicella-zoster virus infections, surgical modalities for genital warts, topical clotrimazole and oral fluconazole for Candida vulvovaginitis, amoxicillin and cefuroxime for Lyme borreliosis, and permethrin for scabies. A synopsis of maternal and fetal risks of other important infections is also included.
Asunto(s)
Varicela/transmisión , Herpes Zóster/transmisión , Transmisión Vertical de Enfermedad Infecciosa , Complicaciones Infecciosas del Embarazo/terapia , Complicaciones Parasitarias del Embarazo/tratamiento farmacológico , Escabiosis/tratamiento farmacológico , Enfermedades Cutáneas Infecciosas/terapia , Candidiasis Vulvovaginal/tratamiento farmacológico , Candidiasis Vulvovaginal/transmisión , Cesárea , Varicela/complicaciones , Varicela/congénito , Varicela/tratamiento farmacológico , Condiloma Acuminado/terapia , Femenino , Enfermedades Fetales/microbiología , Herpes Zóster/tratamiento farmacológico , Humanos , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Enfermedad de Lyme/complicaciones , Enfermedad de Lyme/tratamiento farmacológico , Embarazo , Complicaciones Infecciosas del Embarazo/microbiología , Resultado del Embarazo , Enfermedades Cutáneas Infecciosas/microbiología , Enfermedades Cutáneas Infecciosas/transmisiónAsunto(s)
Varicela , Complicaciones Infecciosas del Embarazo , Varicela/congénito , Varicela/patología , Varicela/fisiopatología , Resultado Fatal , Femenino , Humanos , Recién Nacido , Embarazo , Complicaciones Infecciosas del Embarazo/patología , Complicaciones Infecciosas del Embarazo/fisiopatología , Piel/patologíaRESUMEN
Varicella-zoster virus (VZV) is a teratogen that can cross the placenta and cause the congenital varicella syndrome (CVS), which is characterised by multi-system anomalies. There have been 130 reported cases of CVS from 1947 to 2013. The estimated incidence of CVS was 0.59% and 0.84% for women infected with VZV during the entire pregnancy and for those infected the first 20 weeks of pregnancy, respectively. Nine cases were reported at 21-27 weeks of gestation and one case was identified at 36 weeks. Herpes zoster caused CVS in two cases. Regarding treatment, varicella zoster immunoglobulin treatment, irrespective of gestational age, should be considered in addition to antiviral drugs for women who have been exposed to or infected with virus.
Asunto(s)
Varicela/congénito , Enfermedades Fetales/epidemiología , Herpesvirus Humano 3 , Transmisión Vertical de Enfermedad Infecciosa/estadística & datos numéricos , Complicaciones Infecciosas del Embarazo/epidemiología , Adulto , Varicela/transmisión , Varicela/virología , Femenino , Enfermedades Fetales/virología , Edad Gestacional , Humanos , Incidencia , Recién Nacido , Masculino , Embarazo , Complicaciones Infecciosas del Embarazo/virología , SíndromeRESUMEN
This report provides an update on the surveillance conducted by the Australian Paediatric Surveillance Unit (APSU) during the period January to December 2013. The APSU facilitates national active surveillance of uncommon diseases of childhood including selected communicable diseases. This report includes data on the following conditions: acute flaccid paralysis (AFP), congenital cytomegalovirus (cCMV), congenital rubella, perinatal exposure to HIV and paediatric HIV infection, neonatal herpes simplex virus (HSV), congenital varicella, neonatal varicella, severe complications of varicella and juvenile onset recurrent respiratory papillomatosis (JoRRP). Surveillance of severe complications of influenza was undertaken during the influenza season (July to September 2013).
Asunto(s)
Varicela/epidemiología , Infecciones por Citomegalovirus/epidemiología , Infecciones por VIH/epidemiología , Herpes Simple/epidemiología , Infecciones por Papillomavirus/epidemiología , Paraplejía/epidemiología , Infecciones del Sistema Respiratorio/epidemiología , Rubéola (Sarampión Alemán)/epidemiología , Enfermedad Aguda , Adolescente , Informes Anuales como Asunto , Australia/epidemiología , Varicela/congénito , Niño , Preescolar , Infecciones por Citomegalovirus/congénito , Monitoreo Epidemiológico , Femenino , Infecciones por VIH/congénito , Herpes Simple/congénito , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Rubéola (Sarampión Alemán)/congénitoAsunto(s)
Varicela/congénito , Varicela/diagnóstico , Complicaciones Infecciosas del Embarazo/diagnóstico , Varicela/prevención & control , Varicela/transmisión , Anomalías Congénitas/diagnóstico , Femenino , Edad Gestacional , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Masculino , EmbarazoAsunto(s)
Infecciones por Citomegalovirus/epidemiología , Infecciones por VIH/transmisión , Transmisión Vertical de Enfermedad Infecciosa/estadística & datos numéricos , Parálisis/epidemiología , Vigilancia de la Población , Adolescente , Australia/epidemiología , Varicela/complicaciones , Varicela/congénito , Varicela/epidemiología , Niño , Preescolar , Infecciones por Citomegalovirus/congénito , Infecciones por VIH/epidemiología , Herpes Simple/epidemiología , Humanos , Lactante , Recién Nacido , Gripe Humana/complicaciones , Hipotonía Muscular/epidemiología , Rubéola (Sarampión Alemán)/congénito , Rubéola (Sarampión Alemán)/epidemiologíaAsunto(s)
Varicela , Herpes Zóster , Corticoesteroides/uso terapéutico , Adulto , Anciano , Analgésicos/uso terapéutico , Antivirales/uso terapéutico , Varicela/complicaciones , Varicela/congénito , Varicela/diagnóstico , Varicela/tratamiento farmacológico , Varicela/epidemiología , Varicela/fisiopatología , Varicela/prevención & control , Vacuna contra la Varicela , Niño , Preescolar , Comorbilidad , Contraindicaciones , Diagnóstico Diferencial , Femenino , Infecciones por VIH/epidemiología , Herpes Zóster/diagnóstico , Herpes Zóster/tratamiento farmacológico , Herpes Zóster/epidemiología , Herpes Zóster/prevención & control , Herpes Zóster Oftálmico/tratamiento farmacológico , Humanos , Inmunocompetencia , Huésped Inmunocomprometido , Lactante , Recién Nacido , Masculino , Neumonía Viral/etiología , Neumonía Viral/prevención & control , Embarazo , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Complicaciones Infecciosas del Embarazo/virología , Sobreinfección/prevención & controlAsunto(s)
Varicela/enfermería , Adolescente , Varicela/complicaciones , Varicela/congénito , Varicela/diagnóstico , Vacuna contra la Varicela/administración & dosificación , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Diagnóstico de Enfermería , Embarazo , Sobreinfección/diagnóstico , Sobreinfección/enfermeríaAsunto(s)
Varicela/congénito , Varicela/etiología , Varicela/prevención & control , Vacuna contra la Varicela/uso terapéutico , Femenino , Herpesvirus Humano 3 , Humanos , Recién Nacido , Masculino , Embarazo , Complicaciones Infecciosas del Embarazo/prevención & control , Complicaciones Infecciosas del Embarazo/virología , Factores de Riesgo , Adulto JovenRESUMEN
The coexistence of multiple chromosomal abnormalities and Congenital Varicella Syndrome (CVS) in one patient is a rare event in which anesthetic implications should be considered. This case report describes a 9-year-old female with CVS and a karyotype analysis of 6p21; 16p13 genetic translocations. We conducted a detailed investigation of the consequences of such findings and the potential outcomes in anesthesia of this uncommon incident including thorough research on the characteristics present in each condition. We concluded that: (1) coexistence of two genetic translocations (6p21; 16p13) in one patient, and simultaneously with CVS is undoubtedly an extremely rare event; (2) difficult airway management, potential cardiac dysfunction, risk of pulmonary aspiration, fluid disturbances, and a hard to access peripheral vascularity are among the most important anesthetic implications as a consequence of having all these disorders; (3) ketamine was a safety and efficacious option for sedation during fiber optic bronchoscopy.
Asunto(s)
Anestesia , Varicela/congénito , Varicela/genética , Translocación Genética , Niño , Femenino , Humanos , SíndromeRESUMEN
Widespread use of varicella vaccine in the United States has drastically changed the epidemiology of the disease. Although chickenpox is no longer a ubiquitous childhood infection, varicella-zoster virus continues to circulate in the community and nonimmune pregnant women remain at risk. Varicella can cause severe infection in pregnant women, often complicated by viral pneumonia. Maternal varicella occurring in the first half of pregnancy can cause the rare but devastating congenital varicella syndrome, whereas infection in the late stages of pregnancy may cause neonatal varicella. The best approach to avoiding the morbidity and mortality associated with chickenpox in pregnancy is to screen and vaccinate susceptible reproductive-age women.
Asunto(s)
Vacuna contra la Varicela , Varicela/prevención & control , Complicaciones Infecciosas del Embarazo/prevención & control , Aciclovir/uso terapéutico , Antivirales/uso terapéutico , Quimioprevención , Varicela/congénito , Varicela/diagnóstico , Varicela/tratamiento farmacológico , Susceptibilidad a Enfermedades , Femenino , Herpes Zóster/tratamiento farmacológico , Herpesvirus Humano 3/inmunología , Humanos , Inmunización Pasiva , Inmunoglobulinas/uso terapéutico , Factores Inmunológicos/uso terapéutico , Recién Nacido , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/etiología , Atención Posnatal , Atención Preconceptiva , Embarazo , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Complicaciones Infecciosas del Embarazo/etiología , Atención PrenatalRESUMEN
Congenital varicella syndrome is a rare disorder occurring in less than 1% of maternal varicella during early pregnancy but is associated with high fetal morbidity and mortality. This case report aimed to describe the sonographic features of congenital varicella syndrome following maternal varicella. Well-documented maternal chicken pox was made at 12 weeks of gestation and prenatal ultrasound was performed at 16 weeks. Striking sonographic features included hydropic changes and disseminated calcifications in multiple organs, especially liver and myocardium. Elective termination of pregnancy was done at 17 weeks. The presence of disseminated calcifications could suggest the diagnosis of congenital varicella syndrome.
Asunto(s)
Varicela/congénito , Varicela/diagnóstico por imagen , Enfermedades Fetales/diagnóstico por imagen , Complicaciones Infecciosas del Embarazo , Ultrasonografía Prenatal/métodos , Anomalías Múltiples/diagnóstico por imagen , Aborto Eugénico , Adulto , Femenino , Humanos , Embarazo , Adulto JovenRESUMEN
In our area, varicella is a frequent and essentially benign childhood disease. In contrast, the disease course is likely to be more severe or complicated in the adult, particularly so in the pregnant woman. There is a definite risk of congenital varicella syndrome when the chickenpox occurs during the first 20 weeks of pregnancy. This syndrome predominantly affects the skin, the subcutaneous tissue, muscles and bones, as well as the central nervous system, and can bring about major functional sequellae. In case of chickenpox occurring at the very end of pregnancy, transplacental transfer of the virus may result in a perinatal varicella disease. We propose a approach of each of these different situations.
Asunto(s)
Varicela/congénito , Varicela/transmisión , Enfermedades Fetales/virología , Complicaciones Infecciosas del Embarazo/virología , Antivirales/uso terapéutico , Varicela/prevención & control , Femenino , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Embarazo , Complicaciones Infecciosas del Embarazo/prevención & controlRESUMEN
Congenital varicella syndrome, maternal varicella-zoster virus pneumonia and neonatal varicella infection are associated with serious fetomaternal morbidity and, not infrequently, mortality. Vaccination against varicella-zoster virus can prevent the disease, and outbreak control limits the exposure of pregnant women to the infectious agent. Maternal varicella-zoster immunoglobulin administration before rash development, with or without antiviral medication, can modify the progression of the disease.
Asunto(s)
Varicela , Complicaciones Infecciosas del Embarazo , Varicela/congénito , Varicela/prevención & control , Femenino , Enfermedades Fetales/prevención & control , Edad Gestacional , Humanos , Sueros Inmunes/administración & dosificación , Recién Nacido , Embarazo , Complicaciones Infecciosas del Embarazo/prevención & control , VacunaciónRESUMEN
OBJECTIVE: Routine varicella zoster vaccination for children aged 18 months began in Australia from November 2005. The aim of this study was to compare the current incidence and outcomes of congenital and neonatal varicella in Australia with similarly collected data from 1995 to 1997. METHODS: Active national prospective surveillance was carried out for congenital and neonatal varicella using the Australian Paediatric Surveillance Unit (APSU) for 3.5 years from June 2006. Around 1300 clinicians reported monthly according to predefined case criteria. RESULTS: During the study period the mean monthly return rate of APSU report cards was 93.7%. Two cases of congenital varicella (0.19 per 100 000 live births per annum) and 16 cases of neonatal varicella (2.0 per 100 000 live births per annum) were identified. During 2008 and 2009 no cases of congenital varicella were reported; neonatal varicella rates declined to 0.7 per 100 000 live births per annum, a significant trend (p=0.005) and a reduction of over 85% compared with rates during 1995-1997 (the prevaccination era) and the first year of the current surveillance study. Eleven of 16 neonatal cases followed prenatal maternal infection; seven of the 11 infections were acquired from children, four of whom were living in the same household. Ten (62.5%) infants with neonatal varicella were admitted to hospital, one of whom developed varicella pneumonitis requiring ventilatory support, but none died. Only one infecting contact had been vaccinated. CONCLUSIONS: There has been an apparent reduction of congenital varicella and a significant reduction of neonatal varicella in Australia following the introduction of universal varicella vaccination in 2005.