title: Neonatal herpes simplex virus type-1 central nervous system disease with acute retinal necrosis.
abstract: We report a case of neonatal herpes simplex virus (HSV)-1 central nervous system disease with bilateral acute retinal necrosis (ARN). An infant was presented at 17 days of age with focal seizures. Cerebrospinal fluid polymerase chain reaction was positive for HSV-1 and brain magnetic resonance imaging showed cerebritis. While receiving intravenous acyclovir therapy, the infant developed ARN with vitreous fluid polymerase chain reaction positive for HSV-1 necessitating intravitreal foscarnet therapy. This is the first reported neonatal ARN secondary to HSV-1 and the first ARN case presenting without external ocular or cutaneous signs. Our report highlights that infants with neonatal HSV central nervous system disease should undergo a thorough ophthalmological evaluation to facilitate prompt diagnosis and immediate treatment of this rapidly progressive sight-threatening disease.
authors.affiliation: From the *Division of Paediatric Neurology, Department of Paediatrics, Faculty of Medicine, University of Malaya; †Paediatric and Child Health Research Group, University of Malaya Medical Centre; and ‡Department of Ophthalmology, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Choong Yi
authors.initials: CY
authors.lastname: Fong
authors.forename: Aye Mya Min
authors.initials: AM
authors.lastname: Aye
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Peyman
authors.forename: Norazlin Kamal
authors.initials: NK
authors.lastname: Nor
authors.forename: Subrayan
authors.initials: S
authors.lastname: Visvaraja
authors.forename: Iqbal
authors.initials: I
authors.lastname: Tajunisah
authors.forename: Lai Choo
authors.initials: LC
authors.lastname: Ong
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D002493:Central Nervous System Diseases / Q000188:drug therapy / Q000473:pathology* / Q000821:virology; D005260:Female; D006561:Herpes Simplex / Q000188:drug therapy / Q000473:pathology* / Q000821:virology; D018259:Herpesvirus 1, Human / Q000302:isolation & purification*; D006801:Humans; D007231:Infant, Newborn; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000473:pathology* / Q000821:virology; D015882:Retinal Necrosis Syndrome, Acute / Q000473:pathology* / Q000821:virology
chemical_list: D000998:Antiviral Agents