-Case Reports-

Neonatal Case of Herpes Simplex Virus Encephalitis after Delivery from a Woman Whose Genital Herpes Simplex Virus Infection Had Been Treated with Acyclovir

Sakae Kumasaka¹, Atsushi Takagi², Kentaro Kuwabara² and Makoto Migita³

¹Department of Neonatology, Japanese Red Cross Katsushika Maternity Hospital
²Department of Pediatrics, Nippon Medical School
³Department of Pediatrics, Medical Center for Maternal and Child Health, Nippon Medical School Musashi Kosugi Hospital

A case of herpes simplex virus (HSV) encephalitis in a neonate after delivery from a woman whose genital HSV infection had been treated with acyclovir is reported. The main approach to prevent genital HSV infection in the neonate is interruption of transmission at the time of delivery. Guidelines for prophylactic therapy with acyclovir have been established, but the risk of neonatal infection remains. A fever began to develop in a male neonate delivered vaginally from a 35-year-old woman. Treatment with intravenous acyclovir was started on the basis of a diagnosis of HSV encephalitis, because polymerase chain reaction was positive for HSV in the cerebrospinal fluid. The mother had had a first genital HSV infection during the second trimester, but treatment with injected acyclovir had caused the blisters and erosion to resolve by the time of delivery. Important steps for preventing neonatal HSV infection are the appropriate treatment of mothers with a history of genital HSV infection, the assessment of delivery methods, and the appropriate treatment of neonates.

J Nippon Med Sch 2013; 80: 456-459

Keywords
herpes simplex, neonatal herpes encephalitis

Correspondence to
Makoto Migita, MD, PhD, Department of Pediatrics, Medical Center for Maternal and Child Health, Nippon Medical School Musashi Kosugi Hospital, 1-396 Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa 211-8533, Japan
mmigita@nms.ac.jp

Received, November 9, 2012
Accepted, January 24, 2013