Topic:

Virology and viral infections (non-hiV)

Abstract No.:

ISE.346

Title:

Clinic, evolutes and therapeutic aspect of zoster on pregnancy

Author(s):

N. Como¹, E. Meta², E. Kolovani³, D. Kraja⁴, P. Pipero⁵, A. Harxhi³; ¹University Hospital Centre "Mother Theresa", Infectious Diseases, Tirana, AL/AL, ²University Hospital Centre, Infectious Diseases, Tirane, AL/AL, ³UHC, Infectious diseases, Tirane, AL/AL, ⁴Faculty of Medicine, Service of Infectious Diseases, Tirane/AL, ⁵UHC, infectious diseases, Tirane/AL

Abstract:

Background: Cases of Zoster during pregnancy are rare and complications are still unregistered and not well studied.Aim: Contributing on recognising of clinic, evolutes and therapeutic aspect of Zoster on pregnancyMaterial: Consist of 2 patients with Zoster during pregnancy.
Methods: Studied epidemiological aspects (age, profession, residence); health status, immunodeficit, HIV, ect; obstetrical status (tremester, pregnancy prognoses); infection aspects (clinic form and treatment efficiency).
Results: Case 1. Patient A.K, 23 years-old, 18-week pregnant, primipare, presented with signs and symptoms of  Zoster infection, vesicular eruptions localized in dermatomes C5, C6, C7 and T1. Patient exhibited headache, nausea, vomiting,vertigo, and back pain. Physic symptoms of meningeals affection were missing.Biochemistry, immunology and tumor tracers examinations resulted with no changeLCS flow with increase pressure, clear. Cytological  examination evidented 146 cellule, lymphocyte 95%. Biochemistry examination showed increased of proteins and   normal glucorrhachy. Direct microscopy and microbial culture-negative.Serological tests: ELISA HSV1,2; EBV; CMV-negative; VZV IgM +, IgG +++The case was concepted as Zoster meningitis and was treated with  Acyclovir tablet,800 mg 5 times/die for  10 days.Case 2. Patients A.M, 31 years-old, 30-week pregnant, second pregnancy, came to hospital with thoracal zoster with vesicular eruptions lying in 2 dermatomes,T4 e T5. Initiated with temperature 38C two days, headache, vertigo, back and arm pain. Hemograma, biochemical and immunological examinations resulted normal.Cytological and biochemical examination of LCS resulted normal. Direct microscopy and microbical culture was negative.Serological test: Elisa HSV 1,2 and EBV-negative; CMV IgG +, VZV IgM ++, IgG ++.The case developed normal prognoses of vesicular eruptions and treated with acyclovir 800 mg 5 times/die for 10 days.In both cases CD4 resulted normal.Babies delivery and their development till 12 months old were normal.
Conclusion: 1. Zoster on pregnancy occurred on healthy subjects without imuno and/or organ pathology2. In both cases Zoster was in more than one dermmatom3. One of cases developed lymphocytar meningitis complication4. Meningitis occurred on Zoster  with 4 dermatomes5. Acyclovir treatment was well tolerated 6. Zoster’s development was classic7. Zoster did not affected the babies