Herpes simplex virus infection in the newborn

Abstract

Fourteen cases of neonatal herpes simplex virus infection in 10 boys and 4 girls are described. The disease was disseminated in 9 cases. In 5 cases skin symptoms predominated, and 1 had only central nervous system symptoms. Two had a vesicular eruption when born. Six of the children with disseminated disease died.

EEG recordings were made on 7 patients: 5 had clinical symptoms compatible with encephalitis, and in these the EEG showed periodic complexes, consisting of triangular or sharp waves, a pattern described in adult cases of herpetic encephalitis.

The diagnosis was made by virus isolation and antibody titration. Herpes virus type 2 was the causative agent in all 8 cases where the type was determined. In 5 patients herpes virus antigen was demonstrated using immunofluorescence either in vesicles or throat swabs, in the early phase of the disease.

Two children with generalized disease were treated with intravenous iododeoxyuridine (IDU). The first died, but the other, treated early in his disease, recovered completely.

The clinical picture, complemented by the immunofluorescent technique for virus detection and repeated EEG recordings, should lead to the early diagnosis of herpetic encephalitis in the newborn, and warrant the use of systemic IDU treatment.