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The following text is from an archived Red Book® edition and may not reflect current recommendations or information. To view the current edition, click here.
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Section 3. Summaries of Infectious Diseases
Herpes Simplex
Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures
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NEONATAL. In newborn infants, herpes simplex virus (HSV) infection can manifest as the following: (1) disseminated disease involving multiple organs, most prominently liver and lungs; (2) localized central nervous system (CNS) disease; or (3) disease localized to the skin, eyes, and mouth. Approximately one third of cases are disseminated, one third are CNS disease, and one third affect the skin, eyes, and mouth, although there can be clinical overlap among disease types. In many neonates with disseminated or CNS disease, skin lesions do not develop or the lesions appear late in the course of infection. In the absence of skin lesions, the diagnosis of neonatal HSV infection is difficult. Disseminated infection should be considered in neonates with sepsis syndrome, negative bacteriologic culture results, and severe liver dysfunction. Herpes simplex virus also should be considered as a causative agent in neonates with fever, irritability, and abnormal cerebrospinal fluid (CSF) findings, especially in the presence of seizures. Although asymptomatic HSV infection is common in older children, it rarely, if ever, occurs in neonates.
Neonatal herpetic infections often are severe, with attendant high mortality and morbidity rates, even when antiviral therapy is administered. Recurrent skin lesions are common in surviving infants and can be associated with CNS sequelae if skin lesions occur frequently during the first 6 months of life.
Initial signs of HSV infection can occur anytime between birth and approximately 4 weeks of age. Disseminated disease has the earliest age of onset, often during the first week of life; CNS disease manifests latest, usually between the second and third weeks of life.
CHILDREN BEYOND THE NEONATAL PERIOD AND ADOLESCENTS.
Related text in Red Book:
- Summary of Major Changes in the 2006 Red Book
Red Book 2006: xxix.[Extract] [Full Version] - Human Milk
Red Book 2006: 123-124.[Extract] [Full Version] - Antiviral Drugs
Red Book 2006: 785-789.[Extract] [Full Version] - Prevention of Neonatal Ophthalmia
Red Book 2006: 828-836.[Extract] [Full Version] - Herpes Simplex Ophthalmia
Red Book 2006: 837.[Extract] [Full Version]
This topic has been referenced by these articles:
- Paul, C., Cork, M., Rossi, A. B., Papp, K. A., Barbier, N., de Prost, Y.
(2006). Safety and Tolerability of 1% Pimecrolimus Cream Among Infants: Experience With 1133 Patients Treated for Up to 2 Years. Pediatrics
117: e118-e128
[Abstract] [Full Version] - Kropp, R. Y., Wong, T., Cormier, L., Ringrose, A., Burton, S., Embree, J. E., Steben, M.
(2006). Neonatal herpes simplex virus infections in Canada: results of a 3-year national prospective study.. Pediatrics
117: 1955-1962
[Abstract] [Full Version] - Gesundheit, B., Grisaru-Soen, G., Greenberg, D., Levtzion-Korach, O., Malkin, D., Petric, M., Koren, G., Tendler, M. D., Ben-Zeev, B., Vardi, A., Dagan, R., Engelhard, D.
(2004). Neonatal Genital Herpes Simplex Virus Type 1 Infection After Jewish Ritual Circumcision: Modern Medicine and Religious Tradition. Pediatrics
114: e259-e263
[Abstract] [Full Version] - Lieberman, E., Lang, J., Richardson, D. K., Frigoletto, F. D., Heffner, L. J., Cohen, A.
(2000). Intrapartum Maternal Fever and Neonatal Outcome. Pediatrics
105: 8-13
[Abstract] [Full Version]
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