HSV 11.30.20 PM - NeonatalHerpesSimplex Infections...

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Neonatal Herpes Simplex  Infections MAJ Mark Burnett Pediatric ID Fellow MAR 2003
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Neonatal Herpes Background A Case Study Types of Infections Risks of Infection Diagnostics Treatment Summary
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Herpes Infections “Herpes” – from the  Greek “to creep,  crawl” “Herpetic eruptions”  described as early  as 100 AD 1960’s – HSV1 and  HSV2 differentiated HHV1 – HSV1 HHV2 – HSV2  HHV3 – VZV HHV4 – EBV HHV5 – CMV HHV6 – Causes? HHV7 –  HHV8 - 
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A Case Study – A.B. Term infant born to a 22 y/o GBS+ mother  with no Pmhx of HSV-2 4 doses of IV PCN given PTD ROM <18 hours PTD, no maternal fevers Forceps delivery APGARS of 9/9 Well until fever to 101.7 at 30 hrs of life Fever work-up initiated 
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A.B. WBC 23K (50S 2B 38L) AST 98 ALT 92 CSF 48 WBC 2650 RBC Pro 93/Glu 53 HSV PCR, Enteroviral PCR, HSV Surface cx  – sent Exam unremarkable Amp/Gent/Acyclovir initiated Fevers persisted over next 13 hours, again  spiking to 101.5 AST 147 / ALT 93 two days later
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A.B. – additional info No history of HSV reported in mother,  father Mother without febrile illness Niece with a “cold sore” visited prior to  delivery, and “held the baby” after he  was born LP repeated two days after initial study  with normalization of cell count
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A New Development
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What diagnostic tests could we perform, and  how reliable are they really? Would it be worthwhile to run tests on mom? Is the niece’s “cold sore” a “red herring” –  what are the risks? Bottom line – how worried should we be 
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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HSV 11.30.20 PM - NeonatalHerpesSimplex Infections...

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