Varicella Pneumonia in Pregnancy with Varicella Neonatorum: Report of a Case followed by Severe Digital Clubbing

Summary: The investigation of a patient who developed severe, persistent clubbing of the fingers and toes less than one month after varicella pneumonia is described. Varicella developed in the 38th week of a normal pregnancy and the pneumonia occurred two days later. Eleven days after birth the child also developed chickenpox but it was mild and uncomplicated. The extent of the pneumonia and the timing of the clubbing suggest a cause and effect relationship. However studies of respiratory function begun two weeks after onset, amplified two months later and repeated in a further eight months failed to show any impressive fault. Other possible causes for the clubbing have been excluded by appropriate investigation. Estimations of immuno‐reactive human growth hormone eighteen months after onset have yielded results not notably different from the usual. It is postulated that alterations connected with the acute pneumonia initiated changes which resulted in the clubbing. The coincidence of maximum respiratory involvement with the stress of labour may have been relevant. However the reason for the clubbing and its persistence in a now apparently normal individual remains obscure.