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| {{SI}}
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| {{CMG}} {{AE}} {{AKI}}
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| {{SK}} Fetal varicella syndrome, Congenital varicella-zoster syndrome, Varicella embryo-fetopathy, Varicella embryopathy, Varicella fetopathy, Fetal varicella-zoster syndrome | | {{Roseola}} |
| ==Overview==
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| ==Historical Perspective==
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| *In 1935, the first case resembling neonatal HSV, was described with the presence of intranuclear inclusion bodies in a premature infant in the liver and the adrenals.<ref name="pmid19970188">{{cite journal| author=Hass GM| title=Hepato-Adrenal Necrosis with Intranuclear Inclusion Bodies: Report of a Case. | journal=Am J Pathol | year= 1935 | volume= 11 | issue= 1 | pages= 127-142.5 | pmid=19970188 | doi= | pmc=1910753 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19970188 }} </ref>
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| ==Pathophysiology== | | ==[[Roseola overview|Overview]]== |
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| ===Pathogenesis=== | | ==[[Roseola historical perspective|Historical Perspective]]== |
| The risk for transmission to the neonate from an infected mother is high (30%–50%) among women who acquire genital herpes near the time of delivery and low (<1%) among women with prenatal histories of recurrent herpes or who acquire genital HSV during the first half of pregnancy
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| ====Transmission of infection====
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| *Exposure to the fetus from active genital herpes lesions during delivery, accounts for majority of neonatal herpes cases.
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| *Intrauterine infection accounts for 5% of cases with neonatal herpes simplex.
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| *Postnatal trasmission by contact with HSV shed from infected patients. It accounts for 10% of the cases.
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| ==Epidemiology and Demographics== | | ==[[Roseola classification|Classification]]== |
| *The annual incidence of neonatal herpes is estimated to be 10 cases per 100,000 livebirths.
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| ==Causes== | | ==[[Roseola pathophysiology|Pathophysiology]]== |
| *85% of cases are caused by HSV type I
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| *1%% of cases are caused by HSV type II
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| ==Differentiating Congenital Varicella Syndrome From Other Diseases== | | ==[[Roseola causes|Causes]]== |
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| ==Natural History, Prognosis and Complications== | | ==[[Roseola differential diagnosis|Differentiating Any Disease from other Diseases]]== |
| ===Natural History===
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| ===Complications=== | | ==[[Roseola epidemiology and demographics|Epidemiology and Demographics]]== |
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| ==Diagnosis== | | ==[[Roseola risk factors|Risk Factors]]== |
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| ===History and Symptoms=== | | ==[[Roseola screening|Screening]]== |
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| ===Physical Examination=== | | ==[[Roseola natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
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| | ==Diagnosis== |
| | [[Roseola history and symptoms|History and Symptoms]] | [[Roseola physical examination|Physical Examination]] | [[Roseola laboratory findings|Laboratory Findings]] | [[Roseola electrocardiogram|Electrocardiogram]] | [[Roseola chest x ray|Chest X Ray]] | [[Roseola CT|CT]] | [[Roseola MRI|MRI]] | [[Roseola echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Roseola other imaging findings|Other Imaging Findings]] | [[Roseola other diagnostic studies|Other Diagnostic Studies]] |
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| ===Laboratory Findings===
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| ==Treatment== | | ==Treatment== |
| ==Medical Therapy==
| | [[Roseola medical therapy|Medical Therapy]] | [[Roseola surgery|Surgery]] | [[Roseola primary prevention|Primary Prevention]] | [[Roseola secondary prevention|Secondary Prevention]] | [[Roseola cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Roseola future or investigational therapies|Future or Investigational Therapies]] |
| ==Surgical Therapy==
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| ==Prevention==
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| ===Primary Prevention===
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| *Women without known genital herpes should be counseled to abstain from vaginal intercourse during the third trimester with partners known or suspected of having genital herpes.
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| *Pregnant women without known orolabial herpes should be advised to abstain from receptive oral sex during the third trimester with partners known or suspected to have orolabial herpes.
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| *Type-specific serologic tests may be useful for identifying pregnant women at risk for HSV infection and guiding counseling regarding the risk for acquiring genital herpes during pregnancy.
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| *All pregnant women should be asked whether they have a history of genital herpes. At the onset of labor, all women should be questioned carefully about symptoms of genital herpes, including prodromal symptoms, and all women should be examined carefully for herpetic lesions. Women without symptoms or signs of genital herpes or its prodrome can deliver vaginally. Although cesarean delivery does not completely eliminate the risk for HSV transmission to the neonate, women with recurrent genital herpetic lesions at the onset of labor should deliver by cesarean delivery to reduce the risk for neonatal HSV infection.
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| ===Secondary Prevention===
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| *Suppressive acyclovir treatment late in pregnancy reduces the frequency of cesarean delivery among women who have recurrent genital herpes by diminishing the frequency of recurrences at term. However, such treatment may not protect against transmission to neonates in all cases.
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| *Recommended Regimen : Acyclovir 400 mg orally three times a day OR Valacyclovir 500 mg orally twice a day, beginning from 36weeks of gestation.
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| ==References== | | ==Case Studies== |
| {{reflist|2}}
| | [[Roseola case study one|Case #1]] |