Bermejo GA, Vidal EA, Bayón CM, Gómez-Carpintero GA

Language: Spanish
References: 12
Page: 440-445
PDF size: 214.57 Kb.

ABSTRACT

Background: Neonatal herpes simplex virus (HSV) infection is associated with high morbidity and mortality. This infection can manifest with different clinical manifestations. Congenital infection can occur in pregnant women with no history of infection, vertical transmission occurring at the time of maternal primary infection. To report the congenital infection of a patient in the context of maternal HSV primoinfection, with negative initial maternal serology but seroconversion at 5 months.
Case Report: We present the case of a term newborn, delivered vaginally, who presented with scar lesions at birth and a vesicular lesion on the left elbow. HSV type 1 was detected by polymerase chain reaction (PCR). The mother had no genital lesions at the time of delivery or before, and had a negative serology for HSV. An extension study was performed and early treatment with acyclovir was started and continued for 14 days. Subsequently, maternal and neonatal follow-up was performed, both presenting seroconversions for IgG against HSV-1 5 months after diagnosis.
Conclusions: : Vesicular skin lesions in a neonate should be suspected of HSV infection. The microbiological diagnosis should be made using molecular diagnostic techniques.

REFERENCES

1. Demmler-Harrison GJ. Neonatal herpes simplex virusinfection: clinical features and diagnosis. Waltham (MA):UpToDate; 2022. http://www.uptodate.com/

2. James SH, Kimberlin DW. Neonatal Herpes Simplex VirusInfection. Infect Dis Clin North Am 2015; 29 (3): 391-400.doi: 10.1016/j.idc.2015.05.001

3. James SH, Kimberlin DW. Neonatal herpes simplex virusinfection: epidemiology and treatment. Clin Perinatol 2015; 42 (1): 47-59, viii. doi: 10.1016/j.clp.2014.10.005

4. James SH, Sheffield JS, Kimberlin DW. Mother-to-childtransmission of herpes simplex virus. J Pediatric Infect DisSoc 2014; 3 (Suppl 1): S19-23. doi: 10.1093/jpids/piu050

5. Pinninti SG, Kimberlin DW. Maternal and neonatal herpessimplex virus infections. Am J Perinatol 2013; 30 (2): 113-9.doi: 10.1055/s-0032-1332802

6. Schiffer JT, Corey L. New concepts in understanding genitalherpes. Curr Infect Dis Rep 2009; 11 (6): 457-64. doi:10.1007/s11908-009-0066-7

7. Baquero F, Prieto LM, et al. Guía de la Sociedad Españolade Infectología Pediátrica sobre prevención, diagnósticoy tratamiento de la infección neonatal por virus herpessimplex. An Pediatr (Barc) 2018; 89 (1): 64.e1-64.e10.

8. Pinninti SG, Kimberlin DW. Preventing herpes simplex virusin the newborn. Clin Perinatol 2014; 41 (4): 945-55. doi:10.1016/j.clp.2014.08.012

9. Mathes E, Renee MH. Vesicular, pustular, and bullous lesionsin the newborn and infant. Waltham (MA): UpToDate2018. http://www.uptodate.com/

10. Speer ME. Varicella-zoster infection in the newborn.Waltham (MA): UpToDate 2019. http://www.uptodate.com/

11. López-Medina E, Cantey JB, Sánchez PJ. The mortality ofneonatal herpes simplex virus infection. J Pediatr 2015;166 (6): 1529-32.e1. doi: 10.1016/j.jpeds.2015.03.004

12. Kimberlin D, Powell D, Gruber W, Diaz P, Arvin A, KumarM, Jacobs R, Van Dyke R, Burchett S, Soong SJ, Lakeman A,Whitley R. Administration of oral acyclovir suppressive therapyafter neonatal herpes simplex virus disease limited tothe skin, eyes and mouth: results of a phase I/II trial. PediatrInfect Dis J 1996; 15 (3): 247-54. doi: 10.1097/00006454-199603000-00014