Spectrum: Local Antimicrobial Stewardship, for Markham Stouffville Hospital

Diagnostic Tests

Notes

Infants that are asymptomatic should have surface cultures done at ~24 hours of age or later, because positive cultures taken prior to this time may reflect contamination rather than viral replication.

Infants that are symptomatic may be evaluated and treated before 24 hours of age.

Immediate evaluation and treatment may be considered if the neonate is premature (37 or fewer weeks’ gestation) or there is a maternal prolonged rupture of membranes >4 hours.

All of the following microbiological diagnostic tests should be considered in any neonate with suspected HSV infection or risk of transmission

CSF HSV PCR

If applicable in symptomatic neonates

Viral Swabs

At least 24H after delivery

  • Conjunctivae (each eye must be done with a separate swab)

  • Mouth

  • Nasopharynx

  • Rectum

  • Skin lesions if present

Blood or plasma HSV PCR

If applicable in symptomatic neonates