Neonatal HSV: Difference between revisions

Revision as of 20:58, 2 July 2016

Causative agent: HSV-1 or HSV-2
Definition – “infection acquired peri-natally or postnatally without clinical manifestations at birth or in the first 24 hours of life but with subsequent clinical manifestations in the neonatal period (age less than 29 days)” (1)
ED prevalence:
- 0.2% all neonates
- 0.3% febrile neonates
- 0.5% neonates undergoing LP
Prevalence similar to meningitis (0.4%) in neonates presenting for SBI (2)
Risk associated with age <3 weeks, primary maternal HSV infection at delivery

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

Authors:

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 ==Background==
 *Causative agent: [[HSV-1]] or [[HSV-2]]
-*Risk greatest under 3 weeks of age. Greatest risk factors is primary maternal HSV at delivery.
+*Definition – “infection acquired peri-natally or postnatally without clinical manifestations at birth or in the first 24 hours of life but with subsequent clinical manifestations in the neonatal period (age less than 29 days)” (1)
+*ED prevalence:
-Conjunctival disease may be manifestation of SEM disease.
+**0.2% all neonates
+**0.3% febrile neonates
+**0.5% neonates undergoing LP
+*Prevalence similar to meningitis (0.4%) in neonates presenting for SBI (2)
+*Risk associated with age <3 weeks, primary maternal HSV infection at delivery
 ===Risk Factors in Neonatal Fever===