In utero herpes simplex encephalitis.
BACKGROUND
Transplacental intrauterine infection with herpes simplex virus is an extremely rare complication of primary herpes simplex in pregnancy. Overwhelming fetal sepsis might result in multiorgan failure, including fetal brain death.


METHODS
A 34-year-old multigravida presented with a healing ulcerative genital rash at 16 weeks' gestation. She subsequently reported at 28 weeks' gestation that there had been no fetal movements for 2 weeks. A cardiotocograph showed absent short- and long-term variability. At delivery, an infant was born with disseminated herpes simplex infection in poor condition. Active treatment was subsequently withdrawn, and postmortem examination confirmed disseminated herpes simplex type 2 infection.


CONCLUSIONS
Transplacental herpes simplex is a rare and potentially lethal form of congenital herpes. Overwhelming in utero sepsis should be considered in the differential diagnosis of fetal brain death.
Lee
Anna
A
Department of Obstetrics and Gynecology, Mercy Hospital for Women and University of Melbourne, Victoria, Australia.
Bar-Zeev
Naor
N
Walker
Susan P
SP
Permezel
Michael
M
D000328:Adult; D015148:Cardiotocography; D020803:Encephalitis, Herpes Simplex / Q000175:diagnosis / Q000635:transmission*; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious