Neonatal herpes simplex infection: keys to early diagnosis.
OBJECTIVE
To highlight the clinical features of neonatal herpes simplex (HSV) infection that might facilitate earlier diagnosis.


METHODS
Fifteen year retrospective review of proven neonatal HSV cases from a regional neonatal referral unit.


RESULTS
Fifteen cases reviewed: 10 with central nervous system (CNS) disease, three with skin, eyes or mouth (SEM) disease and two with disseminated disease (DIS). A median 4 day delay occurred between symptom onset and hospital admission. All cases presented after maternity hospital discharge, most commonly with feeding problems and lethargy. Six patients presented with skin lesions; parental genital herpes was reported in three (20%) cases. Seven infants died, four without acyclovir treatment and three of 11 treated cases. Three of five CNS disease survivors and all infants with SEM disease were normal at follow up.


CONCLUSIONS
Acyclovir improves outcome in neonatal HSV infection. To improve outcome further earlier recognition of the non-specific presenting features of the disease is required.
Elder
D E
DE
Neonatal Intensive Care Unit, Princess Margaret Hospital for Children, Perth, Australia.
Minutillo
C
C
Pemberton
P J
PJ
D000212:Acyclovir / Q000627:therapeutic use; D017668:Age of Onset; D000998:Antiviral Agents / Q000627:therapeutic use; D005260:Female; D006561:Herpes Simplex / Q000097:blood / Q000134:cerebrospinal fluid / Q000150:complications / Q000151:congenital* / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D007231:Infant, Newborn; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
D000998:Antiviral Agents; D007075:Immunoglobulin M; D000212:Acyclovir