Predictors of Morbidity and Mortality in Neonates with Herpes Simplex Virus Infections

Abstract

There were no deaths among the 85 infants with localized HSV infection. The mortality rate was significantly higher in the 46 neonates with disseminated infection (57 percent) than in the 71 with encephalitis (15 percent). In addition, the risk of death was increased in neonates who were in or near coma at entry (relative risk, 5.2), had disseminated intravascular coagulopathy (relative risk, 3.8), or were premature (relative risk, 3.7). In babies with disseminated disease, HSV pneumonitis was also associated with greater mortality (relative risk, 3.6). In the survivors, morbidity was most frequent in infants with encephalitis (relative risk, 4.4), disseminated infection (relative risk, 2.1), seizures (relative risk, 3.0), or infection with HSV type 2 (relative risk, 4.9). With HSV infection limited to the skin, eyes, or mouth, the presence of three or more recurrences of vesicles was associated with an increased risk of neurologic impairment as compared with two or fewer recurrences.

Fatal outcome of herpes simplex virus type 1-induced necrotic hepatitis in a neonate

“…The extended histological investigations in our case demonstrate the irreversible damage of this organ. Furthermore, this case confirms that DIC, if occurs, has to be considered as a poor prognostic sign [26]. Although the majority of cases of HSV infection in the newborn are due to HSV-2 [20], our patient had HSV-1 infection.…”

Characterization of an Acyclovir‐Resistant Herpes Simplex Virus Type 2 Strain Isolated from a Premature Neonate

“…First, the resistant isolate was associated with an early recurrence of disseminated disease. Most neonatal recurrences are limited to skin, eye, and mucous membranes alone or occasionally in association with central nervous system disease [9]. The reasons for disseminated recurrence in this infant are unknown.…”

Herpes simplex virus 1 interaction with Toll-like receptor 2 contributes to lethal encephalitis

“…Reactivation of HSV-1 infection is associated with perioral lesions, termed ''fever blisters.'' HSV in the neonate (either HSV-1 or HSV-2) is a far different disease, and may be characterized by a ''sepsis-like'' picture, which includes blood pressure instability, disseminated intravascular coagulation and shock, as well as lethal encephalitis (2,3).…”