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Intrauterine herpes simplex virus infections.

C Hutto, A Arvin, R Jacobs

    The Journal of Pediatrics
    |January 1, 1987
    PubMed
    Summary

    Congenital herpes simplex virus (HSV) infection, caused by HSV-2, leads to severe fetal defects like microcephaly and chorioretinitis. This intrauterine infection can result from primary or recurrent maternal HSV, impacting newborns significantly.

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    Area of Science:

    • Virology
    • Neonatalogy
    • Obstetrics

    Background:

    • Neonatal herpes simplex virus (HSV) infection is typically acquired during birth.
    • Some cases suggest intrauterine acquisition of HSV, leading to congenital malformations.

    Purpose of the Study:

    • To describe the clinical manifestations and outcomes of intrauterine HSV infection in a cohort of infants.
    • To investigate the association between maternal HSV infection (primary or recurrent) and congenital HSV infection.

    Main Methods:

    • Case series describing 13 infants with clinical evidence of intrauterine HSV infection.
    • Diagnosis confirmed by viral isolation of HSV-2 in all cases.
    • Maternal history of genital HSV infection was assessed.

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    Main Results:

    • All 13 infants presented with combinations of defects including skin lesions, scars, microcephaly, hydranencephaly, microphthalmia, and chorioretinitis.
    • HSV-2 was isolated from all infants.
    • Two infants died within the first week; survivors experienced severe neurologic sequelae or blindness.
    • Maternal infections included primary (4) and recurrent (1) HSV, with some mothers asymptomatic.

    Conclusions:

    • Intrauterine HSV infection can occur due to primary or recurrent maternal HSV infection.
    • Congenital HSV infection results in severe fetal abnormalities and significant neonatal morbidity and mortality.
    • Early identification and management of maternal HSV are crucial to prevent severe congenital outcomes.