Neonatal varicella: a report of 26 cases.

Varicella infection usually occurs in childhood and is uncommon in neonates. We reported 26 cases of neonatal varicella seen at the Queen Sirikit National Institute of Child Health, Bangkok, from 1988 to 1995. The sex ratio of male to female was equal. The age of onset was between 6 to 27 days. Twelve cases contracted varicella from mothers who were infected between 6 days before delivery to 2 days after delivery (perinatal varicella) and fourteen cases contracted varicella from mothers or siblings in the postnatal period (postnatal varicella). All babies developed vesicular rash. Intravenous acyclovir was given in high risk and severe cases (nine perinatal and three postnatal varicella patients). Complications of neonatal varicella included clinical sepsis 8 cases (30%), pneumonia 7 cases (26%), pyoderma 9 cases (35%) and hepatitis 1 case (4%). There was no statistical difference between the complications of perinatal and postnatal group (p > 0.05). No death was observed during this study. Clinical manifestations of neonatal varicella varied from mild to severe, depending on the onset of rash in the mother and baby and mode of transmission of the disease. Although we have no varicella-zoster immunoglobulin (VZIG), acyclovir therapy is beneficial in the treatment of neonatal varicella.