Neonates HSV infection

Neonates (<6 to 7 weeks of age) appear to have the highest frequency of visceral and/or CNS infection of any HSV-infected patient population. Untreated, over 70 percent of neonatal herpes cases will disseminate or develop CNS infection. Without therapy, the overall mortality of neonatal herpes is 65 percent, and less than 10 percent of neonates with CNS infection experience normal development. While skin lesions are the most commonly recognized features of disease, many infants do not develop lesions until well into the course of disease. In most series 70 percent of neonatal HSV cases are related to HSV-2 infection, almost all of which result from contact via infected genital secretions at the time of delivery. However, congenitally infected infants have been reported, usually from mothers who acquired primary HSV infection during pregnancy. Neonatal HSV-1 infections are usually acquired postnatally through contact with immediate family members with symptomatic or asymptomatic oral-labial HSV-1 infection or from nosocomial transmission within the hospital. Antiviral chemotherapy has reduced the mortality of neonatal herpes to 25 percent. However, the morbidity, especially in infants with CNS involvement, is still very high.