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Intracerebroventricular and Intravascular Injection of Viral Particles and Fluorescent Microbeads into the Neonatal Brain

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[Neonatal herpes simplex encephalitis: two twins, two cases].

Natalia Conca M¹, Yenis Labraña C, Mariana Bercovich W

¹Programa de Formación en Infectología Pediátrica, Facultad de Medicina, Universidad de Chile, Santiago, Chile. nconca@yahoo.com

Revista Chilena De Infectologia : Organo Oficial De La Sociedad Chilena De Infectologia

|September 1, 2011

Summary

Early diagnosis of herpes simplex encephalitis in newborns is crucial. This case highlights the importance of prompt treatment in twins with central nervous system herpes simplex virus infection to improve outcomes.

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Area of Science:

Neurology
Infectious Diseases
Pediatrics

Background:

Herpes simplex encephalitis (HSE) is a severe neurological infection with significant mortality and morbidity, particularly in neonates.
While antiviral therapies like acyclovir reduce mortality, long-term neurological sequelae remain a concern, underscoring the need for early diagnosis and intervention.

Observation:

A case of neonatal central nervous system herpes simplex virus infection in twins is presented, with non-specific symptoms and requiring intensive care.
One twin required mechanical ventilation, while the other needed hemodynamic support, indicating severe disease presentation.
Diagnosis was confirmed via cerebrospinal fluid PCR, with timing varying between the twins.

Findings:

Both twins received acyclovir treatment, though initiated at different stages of illness.
Initial electroencephalogram and magnetic resonance imaging studies were normal in both infants.
Cerebrospinal fluid PCR became negative for herpes simplex virus DNA in both twins by day 18 of treatment.

Implications:

This case emphasizes the critical role of timely diagnosis and initiation of antiviral therapy in neonatal herpes simplex encephalitis.
Prompt treatment, even with non-specific initial symptoms, is vital for potentially mitigating severe neurological outcomes.
Further research into optimizing diagnostic and therapeutic strategies for neonatal HSE is warranted.