Relapse of neonatal herpes simplex virus infection.
BACKGROUND
Neonatal herpes simplex virus (HSV) infection is a severe disease with high mortality and morbidity. Recurrence of skin vesicles is common.


OBJECTIVE
To determine the features of relapse and identify the factors related to relapse.


METHODS
Thirty two surviving patients with neonatal herpes virus infections were enrolled. All patients received acyclovir treatment. Clinical and virological data were analysed and compared between relapsed and non-relapsed cases.


RESULTS
Thirteen (41%) had either local skin or central nervous system relapse between 4 and 63 days after completing the initial antiviral treatment. Nine patients exhibited local skin relapses, and four developed central nervous system relapses. In one skin and two central nervous system relapse cases, neurological impairment later developed. Type 2 virus infection was significantly related to relapse (odds ratio 10.4, 95% confidence interval 1.1 to 99.0). Patients with relapse had worse outcomes than those without relapse.


CONCLUSIONS
Neonates with HSV type 2 infections have a greater risk of relapse. Relapsed patients have poorer prognoses.
Kimura
H
H
Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan. hkimura@med.nagoya-u.ac.jp
Futamura
M
M
Ito
Y
Y
Ando
Y
Y
Hara
S
S
Sobajima
H
H
Nishiyama
Y
Y
Morishima
T
T
D000212:Acyclovir / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use*; D020805:Central Nervous System Viral Diseases / Q000188:drug therapy / Q000821:virology; D005260:Female; D005865:Gestational Age; D006561:Herpes Simplex / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D012008:Recurrence; D012874:Skin Diseases, Infectious / Q000188:drug therapy / Q000821:virology; D016896:Treatment Outcome; D019562:Viral Load
D000998:Antiviral Agents; D000212:Acyclovir