Korean J Perinatol.  2014 Sep;25(3):195-201. 10.14734/kjp.2014.25.3.195.

A Case of Herpes Simplex Virus Type 2 Encephalitis of a Newborn Delivered by a Mother without Prenatal Screening

• Lee ES
• Kim JY
• Lee KH
• Lee JW
• Lee YJ
• Oh YJ
• Bang JS
• Sung TJ

• KMID: 2280999
• DOI: http://doi.org/10.14734/kjp.2014.25.3.195

Abstract

Neonatal herpes simplex virus (HSV) encephalitis is a rare disease nowadays because of prenatal screening test and management. It shows progressive central nervous system manifestations affecting predominantly temporal and frontal lobes. Early diagnosis of HSV encephalitis is important since even with the early initiation of high-dose intravenous acyclovir therapy, it results in serious morbidity among survivors. A 14-day-old neonate with fever and poor oral intake was admitted via emergency department. The next day she had seizures and the brain was damaged with permanent sequelae despite of early administration of intravenous acyclovir on day 2 of admission. We report a serious case of HSV encephalitis diagnosed as type 2 HSV by polymerase chain reaction and culture of a newborn without proper prenatal screening test.

Keyword

Encephalitis; Herpes Simplex; Newborn

MeSH Terms

Acyclovir
Brain
Central Nervous System
Early Diagnosis
Emergency Service, Hospital
Encephalitis*
Fever
Frontal Lobe
Herpes Simplex
Herpesvirus 2, Human*
Humans
Infant, Newborn*
Mothers*
Polymerase Chain Reaction
Prenatal Diagnosis*
Rare Diseases
Seizures
Simplexvirus
Survivors
Acyclovir

Figure

• 

  Fig. 1. (A) T2-weighted axial images through basal ganglia on hospital day 3, showed no abnormal enhancement. (B) T2-weighted axial images through basal ganglia on hospital day 5, showed generalized increased signal. (C) Diffusion-weighted axial images through basal ganglia on hospital day 5, showed diffuse high signal intensity.

• 

  Fig. 2. At T2-weighted axial images through basal ganglia (A) on hospital day 11, there were multifocal hemorrhages, enlarged ventricles. (B) On hospital day 26, there were marked and diffuse brain atrophy with encephalomalacia of brain. (C) Six months later after discharge, there were more progressed brain atrophy with marked encephalomalacia of entire brain.

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