Abstract: This paper presents 2 neonates with acquired varicella complicated by severe pneumonia admitted to our hospital, and conducts a literature review. Both cases presented with skin rashes as the initial symptom, followed by the gradual onset of fever, cough, shortness of breath, decreased oxygen saturation, and other manifestations. Chest CT examinations confirmed pulmonary consolidation, and both achieved clinical cure after active treatment. A total of 16 relevant literatures on neonatal varicella complicated by pneumonia were retrieved, involving 79 cases. The clinical manifestations mainly included fever, cough, shortness of breath, frothing, milk refusal, and poor mental state on the basis of varicella rashes and severe cases had hypoxemia, respiratory failure, and even pulmonary hemorrhage. Among the 79 patients, were described imaging findings in 17 cases, including 3 cases with lung imaging showing decreased lung transparency, white lung, (large) patchy dense shadows, and flocculent blurred shadows, all of whom died; 1 case with changes such as pulmonary consolidation and atelectasis, and 13 cases mainly with patchy shadows and streak shadows, all of whom achieved clinical cure. Late neonatal varicella has a good prognosis if diagnosed and treated in a timely manner, but there is still the possibility of severe complications. During clinical diagnosis and treatment, attention should be paid to oxygen saturation monitoring, and etiological examinations should be improved in a timely manner to achieve early detection and early treatment, reduce complications, and improve prognosis.

Key words: neonatal varicella, severe pneumonia, pulmonary consolidation, acyclovir