Maternal death secondary to disseminated herpesvirus hominis

Kobbermann, Thomas; Clark, Lauren; Griffin, William T.

doi:10.1016/s0002-9378(15)33254-3

Cited by 30 publications

(4 citation statements)

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“…Primary infection during pregnancy is more commonly associated with complications such as visceral dissemination, particularly if infection is acquired during the third trimester[42]. Therefore, most authorities recommend that primary infection during pregnancy should be treated with systemic antiviral medications.…”

Section: Hsv and Pregnancymentioning

confidence: 99%

New concepts in understanding genital herpes

Schiffer

Corey²

2009

Curr Infect Dis Rep

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Herpes Simplex Virus-2 (HSV-2) is a lifelong infection that causes recurrent genital ulcers and on rare occasions, disseminated and visceral disease. Herpes simplex virus-1 (HSV-1) infection is an increasingly important cause of genital ulcers as well. Herpes simplex virus (HSV) infections are the most common cause of genital ulcers in adults but acquisition and chronic infection are more commonly asymptomatic than symptomatic. Both the symptomatic and asymptomatic forms of HSV are of clinical consequence for several reasons. HSV-2 infection enhances HIV-1 acquisition, as well as transmission. In addition, both sexual and perinatal transmission can occur during asymptomatic viral shedding. Perinatal transmission is of particular concern because neonatal HSV infection results in severe morbiditiy to the newborn. Antiviral medicines are effective for limiting recurrence duration and decreasing transmission likelihood, though no available intervention completely prevents transmission. This highlights the importance of laboratory diagnostics for this lifelong infection, as well as the need for an HSV vaccine.Herpes simplex virus-2 (HSV-2) is the most common cause of genital ulcers, but can replicate in all human tissue and occasionally causes keratitis, hepatitis, pneumonitis, meningitis and neonatal sepsis. Seroprevalence is high worldwide and is 17% in the United States [1]. Though the predominant feature of HSV-2 infection is crops of painful lesions, most seropositive patients are asymptomatic and unaware of their diagnosis [2,3]. In symptomatic and asymptomatic persons, infection is characterized by frequent asymptomatic genital tract shedding [3][4][5], which promotes transmission [6], and persistent inflammation [7]. Immune cell infiltration may explain enhanced human immunodeficiency virus-1 (HIV-1) acquisition [8] and HIV-1 transmission [9] in HSV-2 infected persons. Short courses of DNA nucleoside analogues limit duration of primary infection [10] and recurrences [11], and prevent 50% of transmissions within discordant couples [12]. Because condoms [13,14] and education are only partially effective in preventing transmission, an HSV-2 vaccine is a public health priority. EpidemiologyHSV-2 infection is widely dispersed among populations worldwide [15]. HSV-2 is usually spread via sexual contact and appearance of HSV-2 antibodies in a population correlates with initiation of sexual activity during puberty. HSV-1 is an increasingly important cause of genital ulcer disease in the developed world [1,16]. In much of Asia and Africa, the majority of adults have HSV-1 antibodies and infection is typically acquired during childhood. Since World War II, childhood HSV-1 acquisition has decreased during childhood in certain Western populations. A recent consequence is an upsurge in sexually acquired HSV-1 infections in

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Section: Hsv and Pregnancymentioning

confidence: 99%

New concepts in understanding genital herpes

Schiffer

Corey²

2009

Curr Infect Dis Rep

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“…[4] Genital herpes during pregnancy is said to be associated with an increased risk of spontaneous abortions, intrauterine growth retardation (IUGR) and premature delivery. [5]…”

Section: Introductionmentioning

confidence: 99%

Herpes simplex virus type 2: Seroprevalence in antenatal women

Rathore

Jamwal

Gupta

2010

Indian J Sex Transm Dis

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Aims:To determine the seroprevalence of herpes simplex type 2 (HSV-2) infection in pregnant females, assess the frequency of unrecognized infection and identify the demographic profile and risk factors associated with the seroprevalence.Materials and Methods:Two hundred randomly selected, asymptomatic pregnant females attending the Obstetrics and Gynecology Outpatient Department for a routine antenatal check-up constituted the study group. Serum specimens were screened for HSV-2 infection by detecting IgG class antibodies against HSV-2-specific glycoprotein G-2 using an enzyme-linked immunosorbent assay kit.Results:A seroprevalence of 7.5% was found in our study. Seropositivity was maximum in the age group ≥30 years (22.20%), followed by 26–30 years (9.7%), 21–25 years (2.20%) and ≤20 years (0%). HSV-2 seropositivity was found to be significantly associated with increasing age, parity, number of sexual partners, duration of sexual activity and history of abortions (P < 0.05). No statistically significant correlation was observed between seropositivity and other demographic variables such as place of residence, education, annual family income and occupation (P > 0.05). No statistically significant association of seropositivity with present or past history suggestive of other sexually transmitted infections was found. None of our cases tested positive for human immunodeficiency syndrome (HIV).Conclusion:A relatively low prevalence of HSV-2 seropositivity was found in our study, with a high frequency of unrecognized and asymptomatic infections. Our findings suggest that type-specific serotesting could be an efficient strategy to diagnose clinically asymptomatic HSV-2 infections and, therefore, to reduce the risk of HSV-2 and HIV sexual transmission by prophylactic counseling against unprotected intercourse. It may also be a useful adjunct in detecting cases who present with symptoms not directly suggestive of genital herpes.

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“…A 21-year-old woman at 36 weeks of gestation fell several times at home [22,23]. Over the course of the next 5 days, she developed abdominal pain and fever not responsive to oral antibiotics.…”

Section: Case 7 Missouri Usamentioning

confidence: 99%

Distinguishing Features Common to Dual Fatal Herpes Simplex Virus Infections That Occur in Both a Pregnant Woman and Her Newborn Infant

Price

Wood

2021

Viruses

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Deaths from herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) are rare. A major exception is perinatally acquired HSV-1 or HSV-2 infection where the neonatal death rate is substantial. Fatal HSV infection also occurs occasionally in pregnant women. The goal of this review is to enumerate the reports that describe dual deaths of both a pregnant woman and her newborn from a herpesvirus infection. A total of 15 reports were found in the medical literature, of which five described pregnant women with HSV encephalitis and 10 described women with disseminated HSV infection. When the virus was typed, most cases of dual mother/newborn deaths were caused by HSV-2. Of interest, in two situations caused by HSV-1, the pregnant woman probably acquired her primary HSV-1 infection from one of her children and not by sexual transmission. Complete genomic sequencing was performed on one set of HSV-1 isolates collected from mother (blood) and newborn (blood and skin). The mother’s strain and the newborn’s skin strain were 98.9% identical. When the newborn’s two strains were compared, they were 97.4% identical. Only one mother was tested by the HerpeSelect IgG antibody kit. During the nine days of her undiagnosed disseminated infection preceding her death, her serology was negative. In summary, although dual mother/newborn deaths from HSV infection are rare, they continue to be reported as recently as 2017.

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Maternal death secondary to disseminated herpesvirus hominis

Cited by 30 publications

References 1 publication

New concepts in understanding genital herpes

New concepts in understanding genital herpes

Herpes simplex virus type 2: Seroprevalence in antenatal women

Distinguishing Features Common to Dual Fatal Herpes Simplex Virus Infections That Occur in Both a Pregnant Woman and Her Newborn Infant

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