The Evaluation and Treatment of an Infant Exposed to Nongenital HSV-2: A Case Report

Adv Neonatal Care. 2023 Jun 29. doi: 10.1097/ANC.0000000000001087. Online ahead of print.ABSTRACTBACKGROUND: Pregnant persons with a primary genital herpes simplex virus (HSV) infection can transfer HSV to the fetus or infant through the placenta or birth canal, which can cause significant infant morbidity or mortality. Primary nongenital infections with HSV-1 or HSV-2 in pregnant persons and the risk of infant infection are not well documented, leaving the clinician to make non-evidence-based decisions on evaluation and treatment in such presentations.CLINICAL FINDINGS: A term newborn was delivered vaginally by a pregnant person with a nongenital HSV-2 infection. The pregnant person's rash first appeared around 32 weeks' gestation, started on their lower back, and terminated on the outer left hip. The rash improved but was still present at time of delivery, and this rash was their first known HSV outbreak.PRIMARY DIAGNOSIS: Prenatal exposure to HSV-2.INTERVENTIONS: Diagnostics included the pregnant person's rash surface culture, immunoglobulin G and immunoglobulin M for HSV-1 and -2; infant surface, cerebral spinal fluid (CSF), and serum HSV-1 and HSV-2 polymerase chain reactions (PCRs), infant CSF studies, blood culture, liver function tests, and treatment with intravenous acyclovir.OUTCOMES: This infant remained clinically well during hospitalization and was discharged home at 5 days of life when CSF, surface, and serum PCRs resulted negative.PRACTICE RECOMMENDATIONS: Risk...
Source: Advances in Neonatal Care - Category: Nursing Authors: Source Type: research