AssessmentsNeonatal herpes simplex
Neonatal herpes simplex
USMLE® Step 1 style questions USMLE
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?