Disseminated neonatal herpes simplex virus (HSV) infection represents the most severe form of neonatal herpes, which is associated with high morbidity and mortality. It can be completely prevented and early antiviral treatment can significantly reduce its adverse outcomes. Its early recognition in the neonate can be difficult, since the clinical presentation often mimics bacterial sepsis especially in absence of cutaneous vesicles. We report a case of preterm (twin 1) baby who during the hospital stay developed disseminated neonatal HSV type 1 infection, possibly acquired during kangaroo mother care, as on examination mother was noticed to have herpes labialis. The other twin 2 baby also developed few macular papular rash and was immediately started on antiviral treatment. The purpose of this report is to alert healthcare providers to this potential route of transmission. Furthermore, it is essential to consider neonatal HSV infection in any sick infant who is not responding to standard empirical antibiotic management, even in the absence of herpetic lesions.
