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Infecţia cu virusul varicelo-zosterian (VVZ) este o cauză importantă de morbiditate, cu răspândire la nivel global, ce determină două forme clinice distincte de boală: varicela şi herpesul zoster. Infecţia primară cu VVZ în timpul sarcinii poate avea consecinţe importante atât asupra sănătăţii materne, cât şi fetale. Datele epidemiologice arată că vaccinarea a redus semnificativ numărul infecţiilor cu VVZ atât la mame cât şi la nounăscuţi. Strategiile de vaccinare diferă în funcţie de individul la risc (mamă, nou-născut, copil), de momentul cu riscul cel mai mare de infectare (primul trimestru de sarcină, ultimul trimestru de sarcină sau postnatal) şi de durata imunităţii protectoare după vaccinare. Cea mai frecventă complicaţie a varicelei la mamă în timpul sarcinii este pneumonia variceloasă, care se manifestă cu tuse, dispnee, febră şi tahipnee. Efectele infecţiei VVZ asupra fătului pot fi: sindromul de varicelă congenitală, prematuritate sau avort spontan, varicela neonatală. Varicela congenitală a fost descrisă pentru prima dată în 1947. Ratele de avort spontan, naşterile premature şi decesul intrauterin nu sunt mai mari la mamele cu varicelă în sarcină comparativ cu cele fără varicelă. Infecţia neonatală rezultă din transmisia VVZ de la mamă la făt în perioada perinatală. [ABSTRACT FROM AUTHOR]

Objective. To evaluate the incidence, clinical manifestations and outcomes of neurological complications secondary to varicella in HIV negative hospitalized patients. Methods. Retrospective study on patients with neurological complications related to varicella admitted in a single infectious diseases center between 01 January 2013 and 31 December 2013. Results. Out of 1773 patients with varicella diagnosed in our hospital during the study period, 183 (13.3%) were hospitalized and of these 10 (5.46%) had central nervous system involvement (5 meningo-encephalitis, 4 cerebral ataxia and one polyradiculoneuropathy). The majority were males (8), from urban areas (8), aged from 4 to 38 years (median 6.5 years) and with no history of vaccination against varicella. The most frequent clinical manifestations were: ataxia in 8 cases, vomiting and headaches (7), fever and seizures (6), altered mental status (4) and dizziness and slurred speech (3). CSF analysis showed mild-to-moderate lymphocytic pleocytosis (median 55 cells/µL) in 5 patients and elevated protein levels in one case. Brain imaging was abnormal in 4 of 9 patients, and showed encephalitis of the cerebellum in 2 cases, acute inflammatory central lesions (1) and lumbar-sacral arachnoiditis (1). The outcome under treatment with intravenous acyclovir, corticotherapy, intravenous immunoglobulins, anticonvulsivants was favorable without sequelae in 8 patients. There was one death in a child with an underlying immunodeficiency condition (acute lymphoblastic leukemia) and late initiation of antiviral therapy (after 6 days of onset) and another child developed cavernous sinus thrombosis with slow recovery in a neuropediatric service. Conclusions. The incidence of neurological complications secondary to varicella in hospitalized patients was less frequent compared to the literature data. The outcome of neurological complications was favorable in imunocompetent patients without apparent long-term sequelae. A decrease in the morbidity of neurological complications of varicella will be possible with high vaccination coverage. [ABSTRACT FROM AUTHOR]