HERPES-ZOSTER DURING PREGNANCY - A CASE-REPORT

Maternal varicella (chickenpox) early in pregnancy can cause congenita l defects,(1) while near delivery (7 days before or after) it can caus e severe, even fatal, disseminated varicella in the newborn.(1,2) One percent of infants born to women infected with varicella before 20 wee ks gestation show signs of the congenital varicella syndrome.(1) This is associated with congenital limb hypoplasia, dermatomal skin scarrin g, and/or damage to the eyes and central nervous system.(3) As many of the malformations seen in the congenital varicella syndrome occur in a segmental pattern, it has been postulated that the fetal damage may not be directly due to fetal varicella, but to intrauterine reactivati on of varicella-zoster virus (VZV) causing fetal herpes tester, the sh ort latent period being the consequence of inadequate cell-mediated im munity.(1,2) Maternal varicella later in pregnancy (after 20 weeks) is not associated with the congenital varicella syndrome, presumably bec ause the latent period extends past birth, resulting in infants and ch ildren presenting with herpes tester and no history of varicella infec tion except while in utero.(1,3) There had been concern that maternal herpes tester might permit VZV to infect and damage the fetus.(3) Howe ver, the more recent consensus is that herpes tester in a healthy Roma n during pregnancy carries no risk to the fetus.(1,2,4) This is the fi rst case report of herpes tester during pregnancy reported from Austra lasia.