Neonatal herpes simplex

Summary of Neonatal herpes simplex
Neonatal herpes simplex is a rare but serious condition, usually caused by vertical transmission of the virus during delivery. Mothers with active genital herpes lesions at term should undergo cesarean delivery. A typical sign is vesicular eruption of the skin, eyes, and mouth, which may be accompanied by or progress to disseminated disease. Diagnosis is by viral culture, PCR, immunofluorescence, or electron microscopy. Treatment is with high-dose parenteral acyclovir and supportive care.

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Neonatal herpes simplex

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Neonatal herpes simplex

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High-dose parenteral is the treatment of choice for neonatal herpes simplex virus infection.

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An 8-day-old girl comes to the pediatric clinic because of multiple scalp lesions. She was born 3500-g (7.5-lb), at term, via forceps-assisted vaginal delivery. Mother says there is a cluster of 4 small lesions next to the scalp monitor placement site. She first noted the lesions 4 days prior and was instructed by a nurse to apply Neosporin, but the lesions continue to worsen. The patient's temperature is 38°C (100.4°F), pulse is 120/min, and respirations are 40/min. The scalp lesions appear vesicular and ulcerating, with additional lesions (1-3 mm, cloudy fluid, clusters of 2-4) on occipital and temporal regions in addition to two singular 1 mm lesions on the right eyelid. PCR of lesions, cerebrospinal fluid, and whole blood are obtained. Which of the following is the most likely etiology?