Neonatal HSV

Background

• See also Herpes simplex virus

Pathophysiology

• Generally acquired at time of delivery, though 5-8% may be congenital

Clinical Presentation

• Incubation period 7 to 21 days post-partum, with range from birth to 6 weeks
• Spectrum of disease from cutaneous to disseminated

Disseminated disease

• 25% of cases
• Sepsis syndrome that predominantly affects the liver, lungs, and CNS
• May not have skin findings (25%)
• Usually presents in the first or second week of life
• Should be considered in sepsis without bacterial cause and with liver dysfunction or coagulopathy

Localized CNS disease

• 30% of cases
• Usually presents in the second or third week of life
• May not have cutaneous manifestations
• Can cause seizures

Skin, eye, and mouth disease

• 45% of cases
• Localized to skin, eyes, and/or mouth
• Usually presents in the first or second week of life

Prognosis

• 65% mortality if untreated
• With CNS disease, 80% have developmental problems
• Prognosis much better with isolated cutaneous disease