VZV infection



SYMPTOMS/EXAM


DIAGNOSIS


TREATMENT

Pregnant (+) Chicken Pox Treatment is Similar to that of non-pregnant pts.
- Zovirax (Acyclovir) 800 mg PO 5x/day x 7 days

 
Post-Exposure (+)Hx of VZV
(+)Vaccine
 Nothing
(-)Hx of VZV
(-)Vaccine
(-) Rash - VariZIG (passive immunization): 125 units/10 kg body weight given IM, with a maximum dose of 625 units (5 vials)
- IVIG — For pregnant women who cannot receive VariZIG within 10 days of exposure, clinicians may choose either to administer a single dose of intravenous IVIG at 400 mg/kg 
 
or
closely monitor for signs and symptoms of varicella and institute treatment with acyclovir if illness occurs.

- There are no data on whether acyclovir is beneficial in reducing the risk of varicella after exposure during pregnancy.
(+) Rash - Zovirax (Acyclovir) 800 mg PO 5x/day x 7 days
Source: Uptodate.com


COMPLICATIONS

 

50. A 35-year-old primigravid schoolteacher awakens with a rash clinically consistent with varicella early in the 38th week of her pregnancy. She had a negative varicella titer early in her pregnancy. The clinical course is mild and all vesicles have either crusted over or healed 1 week later. She has an uncomplicated labor and vaginal delivery at 40 weeks gestation, and delivers a healthy-appearing male.
Of the following options, which one is the most appropriate initial management for the newborn?

A) Intravenously administered varicella immune globulin
B) A weight-appropriate dose of intravenous acyclovir (Zovirax)
C) Varicella vaccine
D) Combination treatment with varicella vaccine, intravenous acyclovir, and varicella immune globulin
E) Close observation only

ANSWER: E