Birth acquired herpes

Alternative names:

congenital herpes; herpes - congenital; HSV

Definition:

A herpes infection that is acquired at the time of birth.

Causes, incidence, and risk factors:

Newborn infants can become infected with herpes virus while in the uterus (congenital or intrauterine herpes), during passage through the birth canal (birth acquired herpes), or in the period immediately following birth (neonatal or postpartum herpes). If the mother has an active genital herpes at the time of birth the infant is most likely to become infected during the birthing process. Herpes type 2 (genital herpes) is the most commonly acquired infection although herpes type 1 is also possible.

Intrauterine herpes generally causes severe brain damage, eye disease such as inflammation of the retina (chorioretinitis) and small malformed eyes (microphthalmia) and scarred corneas, and a variety of skin lesions.

Birth acquired herpes can produce localized or systemic disease. Infants may develop a localized skin infection consisting of small fluid-filled blisters (vesicles) that rupture, crust over, and finally heal, often leaving a mild scar behind. Systemic infection generally develops within the first two to three days with irritability, lethargy, fever, skin lesions, seizures, breathing difficulties, shock and bleeding disorders. These infants can develop an encephalitis that, even with prompt treatment, leaves up to 20 to 50% of them with brain damage. Death usually results from brain damage and swelling (cerebral edema), pneumonia, or coagulation abnormalities (disseminated intravascular coagulopathy).

Herpes acquired in the period shortly after birth behaves similarly to birth acquired herpes.