[Successful treatment of therapy refractory shock lung in a newborn infant with congenital varicella using extracorporeal membrane oxygenation]

Klin Padiatr. 1994 Mar-Apr;206(2):92-4. doi: 10.1055/s-2008-1046589.
[Article in German]

Abstract

A newborn with congenital varicella complicated by varicella pneumonia was transferred to our hospital on day 16 of life for the consideration of extracorporeal membrane oxygenation (ECMO). The newborn received varicella zoster immunoglobulin 13 hours after birth since the mother developed a varicella exanthema two days before delivery. On day 10 of life the newborn became clinically symptomatic with red macules and pustules. The chest roentgenogram revealed reticular pulmonary infiltrates in the right upper lobe. Antibacterial chemotherapy was initiated. In the following days the cutaneous lesions progressed, and respiratory symptoms like tachypnoea and oxygen dependence occurred. Chest roentgenograms revealed diffuse reticular and patchy pulmonary infiltrates. On day 14 of life antiviral chemotherapy with acyclovir was started. ECMO was initiated in the veno-arterial mode on day 17 due to severe respiratory failure despite maximal conventional assisted ventilation and carried out for 14 days. With the age of 10 weeks he was discharged from the hospital with mild chronic lung disease without oxygen requirements and without neurological handicap. ECMO might be considered as life saving support in newborns with severe congenital varicella, considered to have a high mortality risk.

Publication types

  • Case Reports

MeSH terms

  • Acyclovir / administration & dosage
  • Chickenpox / congenital*
  • Chickenpox / therapy
  • Combined Modality Therapy
  • Extracorporeal Membrane Oxygenation*
  • Humans
  • Immune Sera / administration & dosage
  • Infant
  • Infant, Newborn
  • Male
  • Pneumonia, Viral / congenital*
  • Pneumonia, Viral / therapy
  • Respiration, Artificial
  • Respiratory Distress Syndrome / congenital*
  • Respiratory Distress Syndrome / therapy
  • Ventilator Weaning

Substances

  • Immune Sera
  • varicella-zoster immune globulin
  • Acyclovir