Affiliations: Department of Pediatrics, University of Arkansas for
Medical Sciences, Arkansas Children's Hospital, Little Rock, AR, USA
Note: [] Correspondence: Bryan L. Burke, Jr., MD, FAAP, Department of
Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's
Hospital, 4301 West Markham, Little Rock, AR 72205, USA. Tel: +1 501 526 1548;
E-mail: BurkeBryanL@uams.edu
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
