Neonates may be susceptible to maternal molluscum contagiosum transmission

Vertical transmission of molluscum contagiosum between a pregnant mother and her child is likely the source of neonatal infections with this pathogen, a recently published case report indicated.

“We have reported a case of congenital molluscum contagiosum infection, the first (to our knowledge) in which maternal infection was clinically documented before vaginal delivery,” researchers from St. Luke’s-Roosevelt Hospital Center in New York City wrote.

A white girl delivered vaginally, at term, developed lesions associated with molluscum over her parietal scalp when she was 2 weeks old. The researchers observed a progressive generalization of the virus over the next three months, until more than 50 pearly papules with a central dell appeared on her face, chest, back and inner left thigh.

The obstetrician of the child’s mother, a 33-year-old white female patient, documented the presence of lesions on the mother’s inner thighs and labia majora since the third trimester of pregnancy. During this time, the mother refused treatment and four papules remained on her medial thighs.

Noting that molluscum contagiosum is highly infectious, the researchers proposed that a mechanism of infection similar to herpes simplex virus and human papillomavirus may be an etiologic factor in neonatal and infantile cases.

Four prior cases of molluscum contagiosum in neonates have also been reported, according to the researchers; however none of these mothers had documented infection at the time of the child’s diagnosis. More research is needed to determine whether protracted contact between a child and an infected external orifice of the uterus is responsible for vertical molluscum contagiosum transmission.

Luke J. Pediatrics. 2010; doi:10.1542/peds.2009-2774

This is an interesting case report of early molluscum contangiosum in a neonate, with lesions noted at two weeks of age. It is presumed that this is due to vertical transmission, a reasonable assumption given the history of maternal perineal molluscum prior to delivery. This neonatal presentation is certainly quite rare, though we know molluscum can present at any age in childhood and adolescence."

– Lawrence F. Eichenfield, MD
Infectious Diseases in Children Editorial Board