Disseminated neonatal herpes simplex virus (HSV) type 2 infection diagnosed by HSV DNA detection in blood and successfully managed by liver transplantation.
We report a case of neonatal herpes presenting with liver failure and disseminated coagulopathy which followed unrecognised maternal primary genital herpes and was diagnosed by herpes simplex virus DNA detection in blood by polymerase chain reaction 2 weeks after initiation of empiric intravenous aciclovir. The child underwent liver transplantation while receiving suppressive antiviral therapy and remains well after 10 months of follow-up.


CONCLUSIONS
our case highlights potential pitfalls in the diagnosis of neonatal herpes and indicates a role for blood herpes simplex virus polymerase chain reaction as a sensitive diagnostic tool in disseminated infection. It is one of very few reports where liver transplantation has been successfully carried out in a neonate with herpes simplex virus-induced liver failure.
Twagira
Mary
M
Department of Infection, King's College Hospital and Guy's King's and St. Thomas' Medical School, London, UK.
Hadzic
Nedim
N
Smith
Melvyn
M
Ramaswamy
Meghna
M
Verma
Anita
A
Dhawan
Anil
A
Knisely
A S
AS
Mieli-Vergani
Giorgina
G
Geretti
Anna Maria
AM
D000328:Adult; D004211:Disseminated Intravascular Coagulation / Q000821:virology; D005260:Female; D006558:Herpes Genitalis / Q000635:transmission; D006561:Herpes Simplex / Q000151:congenital* / Q000175:diagnosis; D018258:Herpesvirus 2, Human / Q000145:classification* / Q000235:genetics; D006801:Humans; D007231:Infant, Newborn; D017093:Liver Failure / Q000601:surgery / Q000821:virology*; D016031:Liver Transplantation; D008297:Male; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious