Approximately two-thirds of neonates with disseminated or CNS disease have skin lesions, but other symptoms may be present before these lesions can be seen. When skin lesions are not present, it can be challenging to diagnose neonatal HSV infection. [ncbi.nlm.nih.gov]

Children with disease caused by HSV infection present in 1 of the 3 fashions. Disease can be localized to the skin, eye and mouth, occurring in approximately 45% of newborns. These babies present at 7–11 days of life on average. [journals.lww.com]

Neonatal CNS HSV disease often presents in the second to third week of life, although earlier presentations can occur. [med.cmu.ac.th]

CT may be negative in the early course of the disease in advanced stages may present with extensive areas of parenchymal hypoattenuation, predominantly in the white matter, as a result of edema or necrosis 3 enhancement usually presents in a gyriform [radiopaedia.org]

CASE PRESENTATION We present an infant born at 36 weeks gestation with a birth weight of 2190 gram. [academic.oup.com]

• Fever

  Factors not associated with neonatal HSV infection were fever, total peripheral white blood cell count, and red blood cells in the CSF. [journals.lww.com]

  The affected person may feel well or suffer from fever, pain and have enlarged local lymph nodes. [dermnetnz.org]

  Generalized symptoms such as fever and malaise may develop, and lymph nodes in the groin may enlarge. Lesions may persist in this stage for a week or more, and complete healing may take four to six weeks. [britannica.com]

  Less Common Symptoms In general, herpes simplex infections cause sporadic recurrences of sores, often with a preceding trigger, such as a cold or a fever—and sometimes without any trigger at all. [verywell.com]

• Respiratory Distress

  In addition to respiratory distress, physical examination revealed marked general erythroderma without vesicles, especially on the face and thorax (figure 1). [fn.bmj.com]

  Inclusion of the newly appreciated features of maternal fever, respiratory distress, and thrombocytopenia might improve the detection of neonatal HSV infection. [journals.lww.com]

  It is usually observed when the infant is 5–9 days old; signs include irritability, seizures, respiratory distress, jaundice, bleeding diatheses, shock, and often vesicular exanthema ( 3, 4 ). [wwwnc.cdc.gov]

  The infant had mild respiratory distress at the time of birth but otherwise appeared normal. On day 3 of birth, the child presented with classical symptoms of HSV. [jcnonweb.com]

  distress, apnea, abdominal distension, hepatomegaly, ascites) CSF pleocytosis Seizures Focal neurologic signs Abnormal neuroimaging Respiratory distress, apnea, or progressive pneumonitis Thrombocytopenia Elevated liver transaminases, viral hepatitis [ncbi.nlm.nih.gov]

• Progressive Hearing Loss

  Congenital cytomegalovirus infection and sensorineural hearing loss. Ear Hear. 1984;5:352–355. 51. Williamson WD, Demmler GJ, Percy AK, et al. Progressive hearing loss in infants with asymptomatic congenital cytomegalovirus infection. [journals.lww.com]

• Normal Hearing

  The change in hearing between birth and 12 months was no different between the 2 treatment groups as 57% and 73%, respectively, and had improved hearing or hearing that remained normal. [journals.lww.com]

• Irritability

  For example, HSV type 1 can occur on the tongue near the teeth, which can cause extra irritation. [verywell.com]

  Signs that your baby may have herpes are: irritability seizures trouble breathing, including grunting, blue appearance (cyanosis), rapid breathing and short periods of no breathing jaundice (yellow skin color) bleeding easily shock Herpes simplex infections [childrenshospital.org]

  Symptoms of CNS herpes include irritability, seizures, tremors (uncontrollable shaking), and lethargy or tiredness. A swelling in the skull is also common. [diseaseinfosearch.org]

  These include low grade fever (100.4 degrees F., or more, rectally), poor feeding, irritability, and skin rash in the form of pimples or blisters, seizures or other similar symptoms that may develop within six weeks following birth. [health.ny.gov]

  Call a GP or your health visitor straight away if your baby: is lethargic or irritable isn't feeding has a high temperature (fever) – find out how to take your baby's temperature has a rash or sores on the skin, eye and inside the mouth These are early [nhs.uk]

• Lethargy

  The examination was significant for mild lethargy, mild jaundice and a few scattered petechiae on the chest. [aafp.org]

  Symptoms of CNS herpes include irritability, seizures, tremors (uncontrollable shaking), and lethargy or tiredness. A swelling in the skull is also common. [diseaseinfosearch.org]

  The following factors were associated with neonatal HSV infection by univariate analysis: maternal primary HSV infection, maternal fever, vaginal delivery, prematurity, postnatal HSV contact, vesicular rash, hypothermia, lethargy, seizures, severe respiratory [journals.lww.com]

  CNS) involvement, also known as skin, eye and mouth disease CNS disease (with or without skin lesions, but without involvement of visceral organs); usually this presentation has non-specific signs including decreased level of consciousness, seizures, lethargy [radiopaedia.org]

  Parents should be warned to report any early signs of infection such as poor feeding, lethargy, fever or any suspicious lesions. [patient.info]

[…] evaluation via a Tzanck preparation Serologic testing (only for determining past HSV exposure) Lumbar puncture and cerebrospinal fluid analysis Immunofluorescent microscopy Brain biopsy Imaging studies: Computed tomography, magnetic resonance imaging See Workup [emedicine.medscape.com]

This study proved that 6 months of valganciclovir therapy was superior to 6 weeks of treatment. [journals.lww.com]

Summarize the treatment and management options available for neonatal herpes infections. [ncbi.nlm.nih.gov]

The most commonly used treatment for congenital herpes is called acyclovir. Other treatment may be necessary for the various symptoms of herpes. [childrenshospital.org]

Initial laboratory evaluation demonstrated thrombocytopenia (13×109/L) and neutropenia (1.7×109/L), and antibiotic and antifungal treatments were administered for suspected sepsis. [fn.bmj.com]

[Psychosomatic treatment of recurrent herpes simplex]. Minerva Med. 1981 May 12;72(19):1207-12. Italian. 8. Fox PA, Henderson DC, et al. [passeportsante.net]

Fortunately, the better knowledge about these infections gained in recent years together with the development of effective antiviral treatments have improved the patients' prognosis. [ncbi.nlm.nih.gov]

Prevention, and Complications Prognosis very good to excellent in healthy adults outcomes in infants born with herpes vary widely according to symptoms Prevention avoid skin-to-skin contact with active, shedding lesions practice safe sex cesarian delivery [medbullets.com]

Another way of classifying this disorder depends on probable outcomes (prognosis). [rarediseases.org]

Following active infection, HSV establishes latent infection that can be reactivated Neonates Better prognosis with herpes simplex virus type 1 (HSV-1) ocular, oral, cutaneous disease Less neurologic morbidity with HSV-1 encephalitis More sequelae from [arupconsult.com]

[…] cytotoxic edema restricted diffusion is less intense compared to infarction beware of T2 shine through due to vasogenic edema GE/SWI: may demonstrate blooming if hemorrhagic T1 C+ (Gd): enhancement usually presents in a gyriform pattern Treatment and prognosis [radiopaedia.org]

The etiology is unknown. A nonspecific hypersensitivity reaction to scabies has been postulated because many patients have been treated for scabies before being diagnosed with IA. [ncbi.nlm.nih.gov]

For genital herpes during pregnancy, see congenital herpes simplex virus infection Herpetic gingivostomatitis Etiology : severe manifestation of an (often primary) HSV-1 infection Mainly in children (∼ 1–6 years), but also immunocompromised patients [amboss.com]

Section 5 - Management and Treatment of Specific Infections Genital Herpes simplex virus (HSV) Infections Etiology Herpes simplex virus (HSV) types 1 and 2. [canada.ca]

Novel Dengue Virus Vaccine Symposiast： Wataru　Akahata Dengue Virus-Blocking Mosquito Trial in Vietnam Symposiast： Dan　Duc Anh Symposium8　Pneumonia in Asian Children 11月12日（月） 10：30～12：00　4F C会場 Chair： LayMyint　Yoshida Molecular diagnosis of pneumonia etiology [c-linkage.co.jp]

Differential diagnosis Because the presentation of herpes simplex virus can vary considerably, many individuals will confuse infection with a variety of other etiologies including: Other ulcerative STIs (syphilis, chancroid) Non-infectious ulcerations [clinicaladvisor.com]

Update on Neonatal Herpes Simplex Epidemiology in the Netherlands: A Health Problem of Increasing Concern? Pediatr Infect Dis J. 2018; 37(8): 806–13. https://doi.org/10.1097/INF.00.... 15. Renesme L. [aaem.pl]

Herpes simplex virus infection in pregnancy and in neonate: status of art of epidemiology, diagnosis, therapy and prevention. Virol J 2009 Occurrence of cytomegalovirus and herpes simplex virus infections in pregnancy. [perinatology.com]

and the Departments of Medicine (L.C., A.W.), Laboratory Medicine (L.C., A.W.), and Epidemiology (A.W.), University of Washington — both in Seattle. Address reprint requests to Dr. [nejm.org]

Review and meta-analysis of the epidemiology of congenital cytomegalovirus (CMV) infection. Rev Med Virol. 2007;17:253–276. 4. Alford CA, Pass RF. Epidemiology of chronic congenital and perinatal infections of man. Clin Perinatol. 1981;8:397–414. 5. [journals.lww.com]

Congenital cytomegalovirus infection: review of the epidemiology and outcome. Obstet Gynecol Surv. 2002; 57 :245–256. [ PubMed ] [ Google Scholar ] 8. Fowler KB, Stagno S, Pass RF. [ncbi.nlm.nih.gov]

[…] settings where the test may be helpful An aid in the diagnosis of congenital herpes simplex virus (HSV) infection in patients younger than 35 days old through the recovery of HSV using viral culture (shell-vial) Clinical Information Discusses physiology, pathophysiology [mayomedicallaboratories.com]

General information Pathophysiology Inoculation : The virus enters the body through mucosal surfaces or small dermal lesions. Neurovirulence : The virus invades, spreads, and replicates in nerve cells. [amboss.com]

Approximately 22% of pregnant women have had a previous exposure HSV-2, and a further 2% or more women acquire the virus during pregnancy. [1] Particularly among young adults, genital herpes infections are increasing caused by HSV-1. [2] Pathophysiology [wikidoc.org]

Pathophysiology Herpes simplex virus is a double stranded DNA virus capable of causing herpes labialis, gingivostomatitis, keratoconjunctivitis and genital herpes, depending on the subtype implicated. [clinicaladvisor.com]

US Preventive Services Task Force. Screening for syphilis infection in pregnancy: U.S. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med. 2009;150:705-10. [39.] T. Herremans, L. Kortbeek, D.W. Notermans. [elsevier.es]

Valganciclovir (32 mg/kg/day in two doses for six months) prevents the development of hypoacusis and improves the neurological prognosis in symptomatic congenital infection due to cytomegalovirus. [ncbi.nlm.nih.gov]

A vaccine that could reduce the spread of herpes would result in many positive outcomes – including preventing infants from dying of neonatal herpes". [who.int]

Preventing neonatal herpes: reducing transmission of HSV infection Identification of pregnant women who have (or are at risk of having) HSV is a critical component of preventing transmission to a baby. [abclawcenters.com]

Herpes prevention You can prevent herpes by practicing safe sex. Condoms can minimize exposure to an active herpes outbreak and prevent transmission of the virus. [healthline.com]