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Guidelines
Pathogens
Antimicrobials
Consult Paediatrics for suspected neonatal HSV infection.
Transmission
Intrauterine Rare occurrence
Perinatal Approximately 85% of transmissions are acquired perinatally as a consequence of the presence of HSV infection (primary or recurrent, symptomatic or asymptomatic) in the genital tract at time of delivery.
Postnatal Approximately 10% of transmissions occur postnatally, most often associated with close contact of the newborn with a caretaker with active HSV infection.
Clinical Manifestations
Skin, eye, mouth (SEM) disease
Central Nervous System (CNS) Disease
Disseminated Disease
At-Risk Infants
Diagnostic Tests
Indications to Begin Acyclovir Therapy
Virologically proven HSV disease.
Clinically suspected HSV disease, pending viral studies.
Asymptomatic but at risk due to exposure (maternal active genital lesions at delivery), with positive surface cultures or positive blood HSV PCR cultures
Empiric Therapy
Disease-Specific Therapy
References
Kimberlin DW, Baley J, Committee on infectious diseases, Committee on fetus and newborn. Guidance on management of asymptomatic neonates born to women with active genital herpes lesions. Pediatrics 2013; 131:e635.
Demler-Harrison GJ. (2017). Neonatal herpes simplex virus infection: Management and prevention. In Weisman LE, Kaplan SL, and Armsby C. (Ed.), UpToDate. Retrieved May 30, 2018, from UpToDate