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Herpes Simplex Virus HSV Infection in Pregnant women and Newborn/Neonate

Herpes Simplex (HSV)

          There are two forms of HSV, HSV1 or HSV2
          Primarily transmitted through the infected maternal genital tract
          The rationale for C-section delivery prior to membrane rupture
          Primary infection with greater transmission risk than reactivation

Clinical Manifestations:

          Most are asymptomatic at birth
          3 patterns of ~ equal frequency with symptoms between birth and 4wks:
          Skin, eyes, mouth (SEM)
          CNS disease
          Disseminated disease (present earliest)
          Initial manifestations very nonspecific with skin lesions NOT necessarily present


          The culture of maternal lesions if present at the delivery
          Cultures in an infant:
          Skin lesions, oro/nasopharynx, eyes, urine, blood, rectum/stool, CSF
          CSF PCR
          Serologies again not helpful given the high prevalence of HSV antibodies in the population


          High dose acyclovir 60mg/kg/day divided q8hrs
          X21days for disseminated, CNS disease
          X14days for SEM
          Ocular involvement requires topical therapy as well


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