Disseminated Neonatal Herpes Infection

Epidemiology

• Disseminated neonatal herpes is the most common and most lethal form of neonatal herpes.(7)
• 50% of infants with neonatal herpes.

Natural History

• Presents usually at 9-11 days of age, but as late as 4 weeks.
• Widespread disease, including: pneumonitis, hepatitis, disseminated intravascular coagulation, with or without encephalitis, exanthem, or kerato-conjunctivitis.

Chest X-ray of herpes pneumonitis

• Symptoms include: irritability, seizures, respiratory distress, jaundice, bleeding, shock, and a characteristic vesicular rash.
• 10-50% will not develop skin lesions during the course of their illness.(8)
• Encephalitis in 60 to 75%.

Prognosis

• Mortality without treatment is >80%, with treatment 57% (9), all but a few survivors impaired (abnormal neurologic status at one year 92% in untreated patients and 86% in treated patients with disseminated disease).

Return to beginning of neonatal HSV document

This document was created and prepared for this Web site by:

• Thomas P. Strandjord, M.D., Assistant Professor
• EMAIL feedback to primary author

 Legal