Chorioretinitis Scarring in a Neonate Secondary to Congenital Herpes Simplex Type 2

Purpose: To describe a rare case of congenital herpes simplex virus type 2 (HSV-2) infection with bilateral retinal involvement in a neonate. Methods: A single case is presented along with a brief literature review. Results: A neonate born to a mother with unrecognized HSV-2 infection presented with skin lesions initially thought to be secondary to amniotic band syndrome. Subsequent evaluation revealed positive skin cultures for HSV-2, suggesting in utero transmission, most likely during the early second trimester. Fundus examination demonstrated large, bilateral hyperpigmented chorioretinal scars consistent with retinal involvement. Conclusions: Congenital HSV infection, although rare, should be considered in neonates presenting with skin lesions and chorioretinitis. Early recognition and prompt initiation of intravenous acyclovir therapy, even before culture confirmation when clinical suspicion is high, are critical to optimize outcomes.