Relapse of neonatal herpes simplex virus; a case report

Introduction: Neonatal herpes simplex virus (HSV) infection is a severe disease with high mortality and morbidity. The disease is caused by both type ۱ (HSV-۱) and type ۲(HSV-۲) forms. The prognosis for neonatal HSV infection has improved since effective antiviral drugs, such as vidarabine and acyclovir, became available. However, themortality from disseminated infection and the morbidity following central nervous system (CNS) infection remain high, despite the early administration of acyclovir.Methods: This is a case report. I obtained data in our hospitalized patient in Ghaem Hospital, Mashhad, Iran. Results: We present a female term neonate referred to our center by left purulent ophthalmic discharge accompanied by photophobia and opacification of underlying stroma at ۲۵ days of age. There was also conjunctival injection and palpebral edema. She had a history of vesicular lesions since birth. Fluorescein-stained ophthalmologic examination, suggested the existence of geographic ulcer due to HSV. Ophthalmic discharge was positive for HSV polymerase chain reaction (PCR) test. She was treated by intravenous Acyclovir for two weeks according to herpetic keratitis diagnosis. She was discharged after resolving epithelial defect with slow improvement of corneal opacification. She presented again in ۴-month of age, by seizure and gastroenteritis and admitted in our center. Her brain MRI was confirmed the herpes encephalitis and she was underwent Acyclovir therapy. Conclusion: Neonatal HSV infection should be treated by suppressive Acyclovir treatment and administration of extended long-term suppressive Acyclovir therapy should be considered to reduce the rate of recurrence.

کلیدواژه ها:

Neonatal Herpes ، Recurrence ، Acyclovir.