Neonatal HSV

Background

• Causative agent: HSV-1 or HSV-2
• Risk greatest under 3 weeks of age. Greatest risk factors is primary maternal HSV at delivery.

Conjunctival disease may be manifestation of SEM disease.

Risk Factors in Neonatal Fever

^Acyclovir if:

• HSV infection in baby or mother
• CSF pleocytoisis
• Concerning skin lesions
• Seizures
• Abnormal LFTs

Management

• Acyclovir 20 mg/kg IV every 8 hours (duration depends on classification)
• If ocular involvement:
  • 1% trifluridine, 0.1% iododeoxyuridine, or 3% vidarabine
  • Optho consult
• As for any febrile neonate SBI evaluation:
  • Ampicillin + gentamycin
    • May substitute gentamycin with cefotaxime/ceftazidime

See Also

• Neonatal conjunctivitis
• Pediatric fever of uncertain source