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Plaquing of Herpes Simplex Viruses
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Mortality from neonatal herpes simplex viremia causing severe hepatitis.

Janet M Basinger1, Steven E Fiester2,3, James W Fulcher2,3,4,5

  • 1Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, 37232, USA. basingerjm@gmail.com.

Forensic Science, Medicine, and Pathology
|July 27, 2019
PubMed
Summary

Neonatal herpes simplex virus infection can be fatal, especially without prenatal care. This case highlights severe herpes hepatitis and liver failure in a neonate, emphasizing the disease

Keywords:
Disseminated herpesHSVHerpes hepatitisHerpes simplex virusNeonatal herpes

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Area of Science:

  • Virology
  • Neonatal Medicine
  • Public Health

Background:

  • Neonatal herpes simplex virus (HSV) infections are rare with adequate prenatal care.
  • Lack of prenatal care and family history of drug abuse are risk factors.
  • HSV infection can lead to severe neonatal disease and mortality.

Observation:

  • A 14-day-old male neonate presented with nonspecific symptoms.
  • No prenatal care was received, and a family history of drug abuse was noted.
  • Autopsy revealed extensive liver and cerebellar necrosis and hemorrhage.

Findings:

  • Histology showed characteristic herpes virus intranuclear ground glass inclusions in the liver.
  • Immunohistochemistry confirmed herpes simplex virus in the liver but not the cerebellum.
  • The neonate suffered from severe herpes hepatitis and fulminant hepatic failure.

Implications:

  • Disseminated neonatal HSV infection carries a high fatality rate.
  • Prompt diagnosis and management are crucial for improving outcomes.
  • This case underscores the importance of prenatal care in preventing severe neonatal infections.