Related Experiment Video
Updated: May 21, 2026
08:46
A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
Neonatal sepsis: A, B, C--don't ever forget herpes
Lucy Anne Fitzgerald1, Diluki Kevitiyagala, Steve Gould
1Department of Women and Children's Health, The Great Western Hospital, Swindon, Wiltshire, UK. lucyfitzgerald@doctors.org.uk
BMJ Case Reports
|June 8, 2012
Summary
Neonatal herpes simplex virus-1 (HSV-1) infection can mimic bacterial sepsis, leading to delayed diagnosis and tragic outcomes. This case highlights the critical need to consider viral etiologies in critically ill neonates presenting with sepsis-like symptoms.
Area of Science:
- Neonatal Medicine
- Virology
- Pediatric Infectious Diseases
Background:
- Neonatal sepsis is a common and serious condition, often treated empirically with antibiotics.
- Bacterial pathogens are the most frequent cause of neonatal sepsis, with established risk factors.
- Herpes simplex virus (HSV) is a less common but potentially devastating cause of neonatal infection.
Observation:
- A 5-day-old infant presented with jaundice and sepsis, initially treated for bacterial infection.
- Despite resuscitation and antibiotics, the infant deteriorated due to metabolic acidosis and disseminated intravascular coagulation.
- Postmortem examination revealed disseminated herpes simplex virus-1 (HSV-1) infection.
Findings:
- The clinical presentation of neonatal HSV-1 can be indistinguishable from bacterial sepsis.
- Delayed diagnosis of HSV-1 can lead to severe morbidity and mortality.
- Empirical antibiotic treatment may not be effective against viral infections like HSV-1.
Implications:
- Pediatricians must maintain a high index of suspicion for viral etiologies, including HSV-1, in neonates with sepsis.
- Diagnostic strategies should include consideration of viral testing in critically ill neonates.
- Further research is needed to guide empirical treatment strategies for neonatal sepsis with uncertain etiology.
Related Concept Videos
01:26Sexually Transmitted Infections
Sexually transmitted infections (STIs) are diseases transmitted primarily through unsafe sexual interactions. Bacteria, viruses, or parasites cause them and can result in severe health complications if untreated.ChlamydiaThe bacterium Chlamydia trachomatis is responsible for the disease Chlamydia, the most common STI in the United States. This peculiar pathogen requires human cells to reproduce, residing intracellularly. The initial infection often goes unnoticed because it typically does not...
01:27Cytomegalovirus Disease
Cytomegalovirus (CMV) disease is caused by human cytomegalovirus, a double-stranded DNA virus of the Herpesviridae family. While primary CMV infection is often asymptomatic in immunocompetent individuals, the virus can cause severe disease in neonates and immunocompromised patients. CMV is the most common cause of congenital viral infection in the United States, and a major pathogen in solid organ and hematopoietic stem cell transplant recipients.CMV is transmitted via bodily fluids, sexual...
01:22Bacterial Meningitis I: Introduction
Bacterial meningitis is a severe, life-threatening inflammation of the meninges, particularly the pia mater and arachnoid mater, affecting the subarachnoid space, ventricles, and cerebrospinal fluid (CSF). If untreated, it can lead to significant neurological complications or death.Causative AgentsCommon pathogens vary with age and immune status. In adults, major organisms include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Streptococcus agalactiae (group B...
01:26Bacterial Meningitis II: Pathophysiology
Bacterial meningitis typically begins when pathogens such as Neisseria meningitidis and Streptococcus pneumoniae colonize the nasopharynx and invade the bloodstream. This process is facilitated by bacterial virulence factors, such as polysaccharide capsules, which resist phagocytosis and complement-mediated killing. Less commonly, bacteria reach the central nervous system via contiguous spread from infections like otitis media or sinusitis, through congenital or acquired dural defects, or...
01:18Viral Meningitis
Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
01:19Encephalitis l: Introduction
Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...