[Recurrent cutaneous herpes in the newborn and acyclovir]

Area of Science:

• Pediatric Infectious Diseases
• Virology
• Dermatology

Context:

• Neonatal herpes simplex virus type 2 (HSV2) infection can manifest with recurrent cutaneous episodes.
• Two cases illustrate recurrent cutaneous herpes following neonatal HSV2 infection.
• Previous reports suggest aciclovir (ACV) for recurrent herpes, including encephalitis.

Purpose:

• To evaluate the role of aciclovir (ACV) in managing recurrent cutaneous herpes after neonatal HSV2 infection.
• To discuss the potential risks of ACV altering host defense mechanisms in neonates and children.

Summary:

• Two infants with neonatal HSV2 infection experienced recurrent cutaneous herpes without systemic spread.
• These infants did not receive ACV post-neonatal period.
• The decision against routine ACV use is based on potential adverse effects on host immunity.

Impact:

• Findings suggest that ACV therapy for recurrent cutaneous herpes in children should be reserved for cases with documented viral progression.
• Highlights the need for careful consideration of ACV's impact on host immune response in pediatric HSV2 management.
• Informs clinical practice regarding the judicious use of antiviral therapy in recurrent pediatric herpes infections.