Birth-acquired herpes

HSV; Congenital herpes; Herpes - congenital

Intrauterine herpes can cause:

• Eye disease, such as inflammation of the retina (chorioretinitis)
• Severe brain damage
• Skin lesions

Birth-acquired herpes can produce localized (in one area of the body) or systemic (throughout the body) disease. Infants may develop only a localized skin infection consisting of small fluid-filled blisters (vesicles) that rupture, crust over, and finally heal, often leaving a mild scar.

A second type of birth-acquired herpes infection leads to encephalitis, an inflammation of the brain that can result in seizures and later brain and nervous system (neurologic) problems. If untreated, it may lead to death.

Disseminated herpes infection is the most dangerous type. In this type, the herpes virus can affect many different internal organs including the liver, lungs, kidneys, and brain. There may or may not be vesicles on the skin. This type of infection is often fatal.

Herpes acquired in the period shortly after birth has symptoms similar to birth-acquired herpes.

Symptoms of birth-acquired herpes include:

• Bleeding easily
• Breathing difficulties
  • Blue appearance (cyanosis)
  • Flaring of the nostrils
  • Grunting
  • Rapid breathing (tachypnea)
  • Short periods without breathing (apneic episodes)
• Coma
• Enlarged liver and spleen
• Jaundice
• Kidney failure
• Lethargy
• Low body temperature (hypothermia)
• Poor feeding
• Seizures
• Shock
• Skin lesions, fluid-filled blisters
• Stress or anxiety

Tests for birth-acquired herpes include:

• DFA test for herpes (scraping from vesicle)
• EEG
• MRI of the head
• Spinal fluid culture
• Vesicle culture

Additional tests that may be done if the baby is very sick include:

• Blood gas analysis
• Coagulation studies (PT, PTT)
• Complete blood count
• Electrolyte measurements
• Tests of liver function