This healthy 31-year-old physician in training, who was in the 10th week of her pregnancy, developed varicella after exposure to an elderly patient with herpes zoster and Varicella-Zoster virus (VZV) pnemonia.
VZV was suspected on the second day of othe eruption when she
had a VZV IgG = 250, VZV IgM=0, and after 2 weeks an IgG 3200 and IgM very elevated confirming the active VZV viral infection. Polymerase chain reaction study confirmed the diagnosis of VZV when she
presented with fever 38,5*C and later 39*C-40*C, fatigue, vomiting, loss of appetite and back pain. The eruption began as single papule and pustule centrally placed in inter-ocular region followed by dissemination to the face and trunk, but the extremities were spared. She was started on oral valacyclovir immediately.
Fetal ultrasound was normal, but she will be followed closely because of the risk of malformations in the fetus related to varicella embryopathy. Cordocentesis, amniocentesis, 'wait and see' policy and therapeutic abortion were discussed. there is not a standard approach and every case should be personalized.
Immunization of high risk individuals (doctors, nurses, etc.) and protection of pregnant women form contact with VZV infection is highly recommended;
disseminated 2-4 mm red papules, vesicles on a red base and pustules