Disseminated neonatal herpes simplex virus: Simplex can be very complex!

Abstract

Neonatal Herpes simplex virus (HSV) infection is an uncommon but highly morbid condition occurring in about 13/100,000 births. A high proportion of survivors have permanent neurologic issues. A majority of neonatal cases happen during birth via preexisting maternal infection. This should be distinguished from congenital herpes, whichis transmitted in utero. There are three primary presentations of neonatal HSV infection. The most common form is skin-eye-mucous membrane (SEM) disease (~45%). The second most common form is central nervous system (CNS) disease (~30%). The most serious and least common form (~25%) is disseminated disease. The morbidity and mortality of this form is very high even after appropriate treatment with high dose acyclovir.