Disseminated neonatal Herpes simplex virus infection preceded by four days of prenatal maternal fever

Abstract

A quick diagnosis for disseminated neonatal Herpes simplex virus (HSV) infection is not easy, potentially affecting morbidity and mortality. We report a case of disseminated HSV occurring at 4 days of life whose mother had fever for 4 days before delivery, a negative history for all sexually transmitted diseases, and a normal genitourinary examination (including visual examination of external genitalia and cervical/vaginal mucosa without colposcopy). A septic work-up done at birth was negative. A second septic work-up at 4 days of age, after clinical deterioration, led to the correct diagnosis and therapy. This case illustrates some of the difficulties in making a rapid diagnosis of neonatal HSV in all cases, especially at this age, and emphasizes the need for inclusion in this differential diagnosis and appropriate presumptive therapy.

Keywords

Neonate - herpes simplex virus - acyclovir - early diagnosis