Neonatal Herpes Simplex Virus Keratitis: Bitter Lessons from a Case Report

Area of Science:

• Neonatal infectious diseases
• Ophthalmology
• Virology

Background:

• Neonatal herpes simplex virus (HSV) infection is a rare but severe condition.
• Ocular involvement, specifically herpetic keratitis, can lead to significant long-term vision problems if not treated promptly.
• Early diagnosis and management are critical for improving outcomes in affected neonates.

Purpose of the Study:

• To present a case of isolated HSV-1 keratitis in a neonate.
• To highlight the potential for late-onset complications, such as HSV encephalitis, even after initial successful treatment.
• To emphasize the importance of considering HSV in neonates with ocular symptoms.

Main Methods:

• Case report of a 25-day-old neonate with ocular symptoms.
• Diagnosis of herpes simplex virus type 1 (HSV-1) keratitis.
• Treatment with intravenous acyclovir.
• Monitoring for systemic complications.

Main Results:

• The neonate presented with isolated HSV-1 keratitis.
• Initial treatment with intravenous acyclovir was successful for the keratitis.
• The patient later developed herpes simplex virus encephalitis, a serious neurological complication.
• This case demonstrates a delayed but severe progression of the infection.

Conclusions:

• Neonatal HSV infection requires vigilant monitoring for systemic spread.
• Ocular symptoms in neonates warrant consideration of HSV, even without systemic signs.
• Prompt treatment of neonatal HSV keratitis is essential, but the risk of late-onset encephalitis persists.