Neonatal HSV

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Revision as of 21:08, 7 February 2020 by Aidan (talk | contribs) (added prognosis)

Background

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