Neonatal Herpes Simplex Infection

Last updated 03.11.12

 

Index

 

Definition

-  Neonatal infection with HSV

 

Features

-  Rare: 3.2 per 100,000

-  Potentially fatal

-  Worse infection if primary in mother

-  Need high index of suspicion

 

Cause

-  HSV (HSV1 or HSV2)

-  Transmission from adult to neonate via direct contact

-  May shed virus when asymptomatic

-  Vertical transmission from mother to fetus

-  Infection at or near time of delivery

-  57% risk if primary infection

-  25% risk if non-primary infection

-  0.05% risk if previous infection but no current S/S

-  0.25-3% risk if previous infection & lesions at delivery

-  90% acquired during labour

-  5% acquired antenatally in-utero

-  5% acquired post partum (breast milk, skin contact, oral lesions)

 

Associated S/S

-  Progressive fever wo bacterial cause

-  Skin lesions

-  Vesicular or atypical bullous pustular lesions at <6 weeks old

-  DDx Diaper dermatis

-  Chorioretinopathy

-  Microcephaly, hydrocephaly

-  Disseminated disease

-  Hepatomegaly

-  Pneumonitis

-  Coagulopathy

-  Seizures

-  CNS disease

 

Ix

-   

 

Mx

-   

 

 

 

 

References

 

New Zealand Herpes Foundation, www.herpes.org.nz