Birth acquired herpes

Alternative names:

congenital herpes; herpes - congenital; HSV

Symptoms:

• history of maternal infection with herpes virus

• poor feeding
• appears unwell or stressed
• skin lesions, fluid filled blisters (vesicles)
• breathing difficulties
  • grunting
  • flaring of the nostrils
  • rapid breathing (tachypnea)
  • short periods without breathing (apneic episodes)
  • blue appearance (cyanosis)
  • intermittent cessation of breathing (apnea)
• shock
• lethargy
• seizures
• coma

Signs and tests:

A very ill baby may develop signs of shock, disseminated intravascular coagulopathy (DIC), or encephalitis.

Tests:

• vesicle culture (grows herpes virus)
• CSF culture (grows herpes virus)
• urine culture (may grow herpes virus)
• Tzanck test (scraping from vesicle demonstrates giant multinucleated cells)
• antigen studies for HSV antigen
• CT scan of the head
• MRI of the head
• blood gas analysis
• coagulation studies (PT, PTT)