Pneumonia, an Unusual Initial Presentation of Neonatal Herpes Infection

Abstract

Neonatal herpes simplex virus (HSV) infection is a life-threatening infection with high morbidity and mortality rates. Neonatal herpes, most commonly due to HSV type 2, is a multi-system disease; however, initial pulmonary presentation is extremely unusual. We describe an infant presenting with progressive respiratory distress, which was the dominant clinical feature of HSV infection during the first days of life. Sepsis work-up and antibiotic treatment were immediately initiated; however, antiviral treatment was not given until the infant's death. HSV type 1 was isolated in nasopharyngeal and endotracheal aspirates. HSV pneumonia should be considered in a newborn with respiratory deterioration not compatible with common neonatal respiratory diseases.

Precision in Cardiovascular Care Using Targeted Neonatal Echocardiography in Lethal Neonatal Disseminated Herpes Infection

“…In addition to cardiac dysfunction and SIRS, TnE-CHO demonstrated a third pattern, which was dominated by features of acute pulmonary hypertension. It is well known that HSV may cause pneumonitis and lung parenchymal disease, 11,12 which was likely a major contributor to oxygenation failure in at least 1 of our cases. Our findings support the literature that the herpetic infective process may also infiltrate the pulmonary vascular bed.…”

Editorial

“…Fetuses, newborns, and young infants are often highly susceptible to unusual pathogens that may be relatively benign in adults. [1][2][3][4][5][6][7][8][9][10] The debate continues on whether these epidemiological differences arise in the unique strains of pathogens, 1,[11][12][13][14][15] immaturity of the immune system, [16][17][18] environmental factors in intensive care units [19][20][21] or in specific climatic conditions that allow these pathogens to reach larger numbers and/or densities. [22][23][24] These conditions have been difficult to treat as the infectious agents affect the fetus/neonate in utero and cannot be treated in a timely fashion, the candidate medications have limited efficacy, or the drugs have had unacceptable short-and long-term adverse effects.…”