Disseminated Neonatal Herpes Infection
Epidemiology
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Disseminated neonatal herpes is the most common and most lethal form of
neonatal herpes.(7)
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50% of infants with neonatal herpes.
Natural History
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Presents usually at 9-11 days of age, but as late as 4 weeks.
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Widespread disease, including: pneumonitis, hepatitis, disseminated intravascular
coagulation, with or without encephalitis, exanthem, or kerato-conjunctivitis.
Chest X-ray of herpes pneumonitis
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Symptoms include: irritability, seizures, respiratory distress, jaundice,
bleeding, shock, and a characteristic vesicular rash.
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10-50% will not develop skin lesions during the course of their
illness.(8)
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Encephalitis in 60 to 75%.
Prognosis
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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).
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