A case of congenital herpes simplex virus infection diagnosed at 8 months of age

Area of Science:

• Neonatal Neurology
• Pediatric Infectious Diseases
• Medical Imaging in Neurology

Background:

• Congenital herpes simplex virus (HSV) infection is a serious neonatal condition, often associated with significant morbidity.
• Early recognition and intervention are critical for improving outcomes in affected infants.

Observation:

• An 8-month-old boy presented with recurrent vesicular eruptions since birth and psychomotor developmental delay.
• Imaging revealed periventricular and thalamic calcifications, with T2-weighted MRI showing high signal intensity in bilateral deep white matter.

Findings:

• The patient was diagnosed with congenital HSV infection, exhibiting a milder phenotype than typically reported.
• Continuous suppressive therapy with valacyclovir was necessary to manage recurrent vesicular outbreaks.

Implications:

• This case underscores the importance of considering congenital HSV infection in neonates with skin lesions and developmental concerns.
• Diagnostic vigilance is key, even in cases with less severe presentations, to ensure timely management and prevent long-term sequelae.