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Varicella-zoster infection in the newborn

Michael E Speer, MD
Section Editors
Leonard E Weisman, MD
Morven S Edwards, MD
Deputy Editor
Carrie Armsby, MD, MPH


Varicella-zoster virus (VZV) is the virus responsible for varicella (chickenpox) and herpes zoster ("shingles"). VZV is a member of the herpesvirus family, along with herpes simplex virus (HSV) types 1 and 2, cytomegalovirus (CMV), Epstein-Barr virus (EBV), and human herpesvirus (HHV) -6, -7, and -8.

Varicella usually is a mild, self-limited illness in healthy children. Rarely, varicella affects the pregnant or postpartum woman, causing problems for the fetus or newborn. Nosocomial acquisition of VZV also can occur in newborns. (See "Clinical features of varicella-zoster virus infection: Chickenpox" and "Varicella-zoster virus infection in pregnancy".)


Most cases of congenital varicella syndrome occur in infants whose mothers were infected between 8 and 20 weeks gestation. However, the overall risk of infection is quite small compared with numerous other viruses acquired during pregnancy. The risk appears to be approximately 2 percent if the infection occurs before 20 weeks and less than 1 percent if it occurs before 13 weeks [1,2]. Intrauterine growth restriction commonly occurs. (See "Varicella-zoster virus infection in pregnancy".)

Characteristic findings of affected infants include some or all of the following in order of the frequency of occurrence [3]:

Cicatricial skin lesions, which may be depressed and pigmented in a dermatomal distribution.


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Literature review current through: Sep 2016. | This topic last updated: Jun 7, 2015.
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