Fatal Neonatal Herpes Simplex Infection Likely from Unrecognized Breast Lesions

Type 1 herpes simplex virus (HSV-1) is very prevalent yet in rare circumstances can lead to fatal neonatal disease. Genital acquisition of type 2 HSV is the usual mode for neonatal herpes, but HSV-1 transmission by genital or extragenital means may result in greater mortality rates. A very rare scenario is presented in which the mode of transmission was likely through breast lesions. The lesions were seen by nurses as well as the lactation consultant and obstetrician in the hospital after delivery of the affected baby but not recognized as possibly being caused by herpes. The baby died 9 days after birth with hepatic failure and disseminated intravascular coagulation. Peripartum health care workers need to be aware of potential nongenital (including from the breast[s]) neonatal herpes acquisition, which can be lethal.

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Neonatal Herpes Simplex Infection Possibly Acquired via Maternal Breast Milk

PEDIATRICS ◽

10.1542/peds.63.2.250 ◽

1979 ◽

Vol 63 (2) ◽

pp. 250-251

Author(s):

Lisa M. Dunkle ◽

Rose Rita Schmidt ◽

Dennis M. O'Connor

Keyword(s):

Herpes Simplex Virus ◽

Herpes Simplex ◽

Breast Milk ◽

Neonatal Herpes ◽

Simplex Infection ◽

History Of ◽

Neonatal Herpes Simplex ◽

Simplex Virus ◽

Hsv 1

A newborn infant with disseminated herpes simplex virus type 1 (HSV-1) infection was determined serologicallv to have acquired the infection postnatally; his mother was found to have HSV-1 in her breast milk but had no history of genital lesions and negative viral cultures of cervix, vagina, and throat. We suggest that HSV-infected maternal breast milk may be a source of this infection for susceptible infants.

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Diagnosis of Neonatal Herpes Simplex Infection from the Placenta

Case Reports in Pediatrics ◽

10.1155/2020/8898612 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Amanda E. Smith ◽

Amy McKenney ◽

Laura Rabinowitz ◽

Anirudha Das

Keyword(s):

Herpes Simplex ◽

Intrauterine Infection ◽

High Rate ◽

Pathological Examination ◽

Neonatal Herpes ◽

Fetal Demise ◽

First Case ◽

Simplex Infection ◽

Neonatal Herpes Simplex ◽

Simplex Virus

Due to a high rate of fetal demise and premature birth in intrauterine HSV infection, the outcome in neonates is usually adverse. A female preterm infant with a gestational age of 25 1/7 weeks with expected early clinical course tested positive for neonatal herpes simplex virus (HSV) 2 after the neonatologist was informed of positive immunohistochemistry for the virus on the fifth day of life by the pathologist. Pathological examination of the placenta had revealed subacute necrotizing inflammation with stromal cell necrosis suggestive of intrauterine infection, possibly ascending due to prolonged rupture of membranes. To the best of our knowledge, this is the first case wherein placental pathology indicated exposure to HSV in utero before the infant presented with signs or symptoms of neonatal HSV resulting in a favorable outcome for the infant. Due to the variability of presentation of intrauterine HSV infection, pathological examination of the placenta in the first 2–5 days of life in premature infants can provide clues to the diagnosis of neonatal HSV which may significantly impact the outcome.

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Neonatal Herpes Simplex Infection

Clinical Microbiology Reviews ◽

10.1128/cmr.17.1.1-13.2004 ◽

2004 ◽

Vol 17 (1) ◽

pp. 1-13 ◽

Cited By ~ 234

Author(s):

David W. Kimberlin

Keyword(s):

Herpes Simplex ◽

Neonatal Herpes ◽

Cns Disease ◽

The Past ◽

Simplex Infection ◽

Number Of Patients ◽

History Of ◽

Neonatal Herpes Simplex ◽

Simplex Virus ◽

Disseminated Disease

SUMMARY Tremendous advances have occurred over the past 30 years in the diagnosis and management of neonatal herpes simplex virus (HSV) disease. Mortality in patients with disseminated disease has decreased from 85 to 29%, and that in patients with central nervous system (CNS) disease has decreased from 50 to 4%. Morbidity has been improved more modestly: the proportion of patients with disseminated disease who are developing normally at 1 year has increased from 50 to 83%. While the proportion of patients with neurologic morbidity following CNS disease has remained essentially unchanged over the past three decades, the total number of patients who are developing normally following HSV CNS disease has increased due to the improved survival. Although additional therapeutic advances in the future are possible, more immediate methods for further improvements in outcome for patients with this potentially devastating disease lie in an enhanced awareness of neonatal HSV infection and disease. A thorough understanding of the biology and natural history of HSV in the gravid woman and the neonate provides the basis for such an index of suspicion and is provided in this article.

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Disseminated Neonatal Herpes Simplex Virus Type 1 from a Maternal Breast Lesion

PEDIATRICS ◽

10.1542/peds.71.3.455 ◽

1983 ◽

Vol 71 (3) ◽

pp. 455-457

Author(s):

JOHN Z. SULLIVAN-BOLYAI ◽

KENNETH H. FIFE ◽

RICHARD F. JACOBS ◽

ZACHARY MILLER ◽

LAWRENCE COREY

Keyword(s):

Herpes Simplex Virus ◽

Herpes Simplex ◽

Breast Lesion ◽

Male Infant ◽

Neonatal Herpes ◽

Route Of Transmission ◽

Near Term ◽

Neonatal Herpes Simplex ◽

Simplex Virus

Most cases of neonatal herpes simplex virus (HSV) result from contact with infected secretions from the maternal genital tract.1 Postnatal acquisition of neonatal HSV infections, a subject recently reviewed by Light,2 is uncommon. We report a case of fatal neonatal HSV-1 infection acquired by contact with a maternal breast lesion. Restriction endonuclease "fingerprinting" revealed a similar pattern in the viruses isolated from the maternal breast lesion and the infant's skin lesion. The purpose of this report is to alert physicians of this potential route of transmission, especially in women experiencing primary mucocutaneous HSV infection at or near term. CASE REPORT A 3,693-g male infant was born to a 21-year-old white primigravida after an uneventful term pregnancy.

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A Cluster of Neonatal Herpes Simplex Infections Without Mucocutaneous Manifestations

PEDIATRICS ◽

10.1542/peds.73.2.194 ◽

1984 ◽

Vol 73 (2) ◽

pp. 194-198

Author(s):

Antonio J. Amortegui ◽

Trevor A. Macpherson ◽

James H. Harger

Keyword(s):

Herpes Simplex Virus ◽

Herpes Simplex ◽

Restriction Endonuclease ◽

Intrauterine Infection ◽

Neonatal Herpes ◽

History Of ◽

Different Strains ◽

Neonatal Herpes Simplex ◽

Simplex Virus ◽

Hsv 1

Three cases of neonatal disseminated herpes simplex virus (HSV) infection are reported. They were all due to different strains of HSV-1, according to restriction endonuclease studies, and they represent the first cluster of neonatal HSV infection at Magee-Womens Hospital. The neonatal symptoms occurred early, suggesting intrauterine infection. None of the babies had mucocutaneous lesions, and the mothers were asymptomatic and had no history of previous genital HSV infection.

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Neonatal Herpes Simplex Virus Infections

Pediatrics in Review ◽

10.1542/pir.7.4.119 ◽

1985 ◽

Vol 7 (4) ◽

pp. 119-126

Author(s):

Richard J. Whitley ◽

Cecelia Hutto

Keyword(s):

Herpes Simplex Virus ◽

Herpes Simplex ◽

Viral Infections ◽

Fatal Case ◽

Molecular Characteristics ◽

Neonatal Herpes ◽

Herpes Simplex Viruses ◽

Neonatal Herpes Simplex ◽

Simplex Virus ◽

Hsv 1

Infections caused by herpes simplex viruses have been recognized since ancient Roman times, when Herodotus associated mouth ulcers and lip vesicles with fever. However, neonatal herpes simplex infection was not identified as a distinct disease until centuries later. Only 50 years ago, the first written descriptions of neonatal herpes were attributed nearly simultaneously to Hass, who described the histopathologic findings in a fatal case, and to Batingani who described a newborn child with herpes simplex virus (HSV) keratitis. For several decades our understanding of neonatal infections with herpes simplex virus was predicated upon histopathologic descriptions of the disease. These indicated a broad spectrum of involvement in infants. In the mid-1960s, Nahmias and Dowdle demonstrated two antigenic types of herpes simplex virus, HSV-1 and HSV-2. Recognition of these types prompted a rapid series of developments leading to a better characterization of the biochemical and molecular characteristics of the virus. One consequence of these advances has been the development of methods of typing of viruses which have been utilized to define the epidemiology of HSV infections. Herpes simplex viral infections "above-the-belt," primarily of the lip and oropharynx, have been found in most cases to be associated with HSV-1, whereas infections "below-the-belt" are usually caused by HSV-2.

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Fatal disseminated neonatal herpes simplex virus type 1 infection in neonates in a forensic setting

Forensic Science Medicine and Pathology ◽

10.1007/s12024-016-9834-5 ◽

2017 ◽

Vol 13 (1) ◽

pp. 99-101 ◽

Cited By ~ 2

Author(s):

Jia Hao Wu ◽

Sarah Parsons

Keyword(s):

Herpes Simplex Virus ◽

Herpes Simplex ◽

Virus Type ◽

Herpes Simplex Virus Type ◽

Neonatal Herpes ◽

Forensic Setting ◽

Neonatal Herpes Simplex ◽

Simplex Virus

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Neonatal Herpes Simplex Virus Type-1 Central Nervous System Disease With Acute Retinal Necrosis

The Pediatric Infectious Disease Journal ◽

10.1097/inf.0000000000000137 ◽

2014 ◽

Vol 33 (4) ◽

pp. 424-426 ◽

Cited By ~ 5

Author(s):

Choong Yi Fong ◽

Aye Mya Min Aye ◽

Mohammadreza Peyman ◽

Norazlin Kamal Nor ◽

Subrayan Visvaraja ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Herpes Simplex Virus ◽

Herpes Simplex ◽

Central Nervous System Disease ◽

Neonatal Herpes ◽

System Disease ◽

Neonatal Herpes Simplex ◽

Simplex Virus

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Diagnosis and treatment of herpes simplex virus (HSV) infection in the newborn

Microbiology Australia ◽

10.1071/ma08194 ◽

2008 ◽

Vol 29 (4) ◽

pp. 194

Author(s):

Cheryl A Jones

Keyword(s):

Herpes Simplex Virus ◽

Herpes Simplex ◽

Neonatal Infection ◽

The United States ◽

Lethal Infection ◽

Neonatal Herpes Simplex ◽

Simplex Virus ◽

Hsv 1

Neonatal herpes simplex virus (HSV) disease is a rare but sometimes highly lethal infection. The reported incidence in Australia is approximately four cases per 100,000 live births. HSV type 2 (HSV-2) is the predominant serotype that causes infection in the newborn in the United States, whereas in Australia 1 neonatal infection is usually caused by HSV type 1 (HSV-1), most likely due to greater prevalence of oral and genital HSV-1 disease in this country 3. Diagnosis of neonatal infection requires a high index of clinical suspicion as signs are non-specific, and is usually confirmed by isolation of HSV from skin vesicle or detection of HSV DNA in the cerebrospinal fluid, blood or surface swab. Treatment requires intravenous aciclovir for 14-21 days depending on the form of disease.

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