Neonatal Herpes Infection: A Review

Leslie A. Parker, MSN, RNC, NNP; Sheryl J. Montrowl, MSN, RNC, NNP

Disclosures

NAINR. 2004;4(1) 

In This Article

Abstract and Introduction

Herpes simplex virus (HSV) is a devastating infection in the neonatal patient. The incidence of maternal HSV infection and consequent neonatal infection has increased significantly over the last several decades due to changing sexual practices. Despite the improvements in outcome with the use of high dose acyclovir, a delay in the diagnosis of HSV has been associated with progression of the disease and increased mortality and morbidity. Even with adequate treatment, permanent sequalae, such as developmental delay, cerebral palsy, blindness, and persistent seizures may occur. Since the onset of symptoms can occur up to four weeks of age, clinicians caring for infants in any setting including the neonatal intensive care unit, the well baby nursery, pediatric floors, emergency rooms, and outpatient clinics must be fully aware of the clinical presentation, evaluation, treatment, and prevention of neonatal HSV infection to facilitate successful diagnosis and treatment of this deadly disease.

Since the 1970s, the medical community has seen a dramatic increase in the incidence of herpes simplex virus (HSV) infection in the general population.[1,2] This surge in the prevalence of herpes infection in women of childbearing years has unfortunately led to a comparable increase in the incidence of neonatal herpes infection.

Herpes infection in the newborn is often a devastating disease associated with an extremely high mortality and morbidity.[1] Although tremendous advances in the provision of care to the neonatal patient have been made, the incidence of neonatal herpes has continued to increase.[1,2] Herpes infection in the newborn is extremely virulent; even aggressive therapy may be only minimally successful. Delay in both the diagnosis and treatment of neonatal herpes infection has been associated with rapid progression of the disease process and a dramatic increase in both the mortality and morbidity.[3] Therefore, clinicians caring for infants in any setting including the neonatal intensive care unit (NICU), the well baby nursery, pediatric floors, emergency rooms, and outpatient clinics must be fully aware of the clinical presentation, evaluation, treatment, and prevention of neonatal HSV infection to successfully diagnose and treat this deadly disease.

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