[Neonatal herpes simplex encephalitis--report of a case and summary of reported patients in Japan]

A 13-day-old male new-born was admitted to our hospital because of prolonged fever from eleventh day of his life. Physical examinations were unremarkable with good feeding ability, but an increase of the white cell count in the cerebrospinal fluid was noted. In spite of the intravenous administration of antibiotics and gamma-globulin, intractable focal seizures were developed on the fifth day of his illness, and his consciousness level was decreased. Herpes simplex virus (HSV) encephalitis was strongly suggested by the results of brain computed tomography (low density on the right temporal region) and electroencephalography (right temporal sharp waves recorded in concordance with clonic seizures of the left arm), and acyclovir was started on the sixth day of his illness. His condition was remarkably improved, and then he could drink milk again on the tenth day of his illness. The changes of the antibody titers supported our diagnosis. Among the previously reported twenty-nine patients of neonatal HSV encephalitis in Japan, seven died and twelve were severely handicapped. These grave prognoses may be improved by the early administration of antiherpetic agents to the febrile neonates with intractable (focal) seizures regardless of the absence of mucocutaneous lesions.