title: Recurrent neonatal herpes presenting initially with hoarseness.
abstract: This report describes a newborn with recurrent herpes simplex meningoencephalitis despite vigorous antiviral therapy. The course is unusual in that the presenting symptom was hoarseness. Despite probable adequate acyclovir levels in the spinal fluid, a second episode or progression of herpetic encephalitis occurred, suggesting impairment of host defenses, particularly cellular immunity. This episode was treated with both acyclovir and vidarabine. Pharmacokinetics of the antiviral therapy and immune responses are discussed.
authors.affiliation: Department of Pediatrics, Marshfield Clinic, Wisconsin 54449.
authors.forename: J C
authors.initials: JC
authors.lastname: Opitz
authors.forename: M A
authors.initials: MA
authors.lastname: Kettrick
authors.forename: B J
authors.initials: BJ
authors.lastname: Sullivan
mesh_terms: D000212:Acyclovir / Q000493:pharmacokinetics / Q000627:therapeutic use; D006561:Herpes Simplex / Q000150:complications* / Q000188:drug therapy; D006685:Hoarseness / Q000209:etiology*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008590:Meningoencephalitis / Q000209:etiology*; D012008:Recurrence; D014740:Vidarabine / Q000627:therapeutic use
chemical_list: D014740:Vidarabine; D000212:Acyclovir