Related Experiment Videos
[Neonatal herpes: recurrence after treatment with acyclovir]
M A Le Gall1, J F Boccara, C Francoual
1Service de pédiatrie B, hôpital Saint-Vincent-de-Paul, Paris, France.
Insights
Neonatal herpes infection relapsed in a 1.5-month-old infant despite acyclovir (ACV) treatment. This case highlights the need for longer ACV therapy in infants due to potential neurological complications.
Area of Science:
- Pediatric Infectious Diseases
- Neonatal Neurology
- Virology
Background:
- Neonatal herpes simplex virus (HSV) infection poses significant risks.
- Early treatment with acyclovir (ACV) is standard care.
- Relapse of HSV infection is uncommon in neonates but documented in older populations.
Observation:
- A 1.5-month-old infant experienced a relapse of cutaneous herpes with meningitis.
- The infant had received initial ACV treatment for neonatal HSV infection.
- An immunological response to HSV was detected 2.5 months post-infection onset.
Findings:
- The case suggests that HSV relapse can occur in infants even after appropriate ACV therapy.
- The patient's age and immunological profile may influence relapse risk.
- The mechanism of ACV action and viral shedding patterns are considered.
Implications:
- Extended ACV treatment duration is recommended for neonatal HSV relapse to mitigate neurological sequelae.
- This case underscores the importance of vigilant monitoring for relapse in treated infants.
- Further research into optimal treatment durations for neonatal HSV is warranted.
Abstract:
A case of cutaneous herpes relapse with meningitis is reported in a 1.5 month-old infant treated during the first three weeks of life with acyclovir (ACV) for a neonatal herpes infection. Such a relapse has previously been described in older children as well as in adults. In this case report, there was immunological response to herpes virus infection, 2.5 months after the onset of the infection. The relapse is discussed taking into account the mechanism of action of ACV, the age of the patient and the immunological response profile. Because of the high risk of neurological involvement, we suggest that the relapse should be treated with ACV for a period of time longer than actually recommended.