CONGENITAL/NEONATAL

HSV

The risk to infants exposed to HSV lesions during delivery varies in different circumstances: - 25-60% for first-episode genital HSV - 2% for recurrent genital HSV - ** Approximately 75% of infants who contract HSV have been born to women who had no history or clinical findings of genital HSV infection during or preceding pregnancy. Clinical Manifestations: Skin/Eyes/Mouth (1st week) Disseminated (2nd week) CNS only (3rd week) Diagnosis: Swabs for culture from: conjunctivae, nasopharynx, mouth, rectum, and skin vesicles between 12 and 24 hours of life. Testing as above for all infants born to mothers with: - Any active lesion primary or recurrent outbreak - Cultures positive for HSV without lesions Treatment: Acyclovir 20mg/kg/dose q8hr If any neonate is symptomatic: In addition to the above cultures, also collect: - CSF HSV DNA PCR, CSF studies, start Acyclovir - Blood culture, CMP, CBC, start Amp/Gent Red Book 2011