Symptoms and Signs of Neonatal Herpes
Regardless of whether you are a parent of a newborn baby or not, you should know about the symptoms and signs of Neonatal Herpes. Fortunately, it is not a life-threatening disease and can be treated. However, it is important to know that Neonatal Herpes can lead to severe complications if it is not treated quickly.
Diagnosis
During pregnancy, the mother may be exposed to the herpes simplex virus (HSV). This can result in an intrauterine HSV infection, which can be disseminated into the neonatal period. In addition, HSV is transmitted to the neonate by the mother during vaginal delivery.
There are three main types of neonatal herpes infection: intrauterine HSV infection, congenital HSV infection, and disseminated HSV infection. The neonatal period is a period of high risk because the newborn’s immune system is underdeveloped. Therefore, early recognition and treatment are essential.
There are several methods for obtaining diagnostic samples. The most common specimens include CSF and skin lesions. PCR testing is a rapid test for identifying viral DNA in skin lesions and CSF. It is also useful for establishing the diagnosis of neonatal herpes infection.
Disseminated neonatal herpes is characterized by characteristic cutaneous lesions that begin as erythema and progress to erosions, crusts, and vesicles. Usually, these lesions appear within the first or second week of life. However, in some neonates, they may not be present. PCR testing of CSF and blood is positive in more than 90% of infants with disseminated disease.
A lumbar puncture is usually performed when a neonate is suspected of having an HSV infection. In addition, coagulation studies are recommended. In asymptomatic neonates, contact precautions are recommended until lesions have crusted.
Treatment of neonatal herpes involves parenteral acyclovir therapy (acyclovir 20 mg/kg every 8 hours) in cases of limited disease. The duration of therapy is determined by the severity of the disease. It is also important to maintain hydration and avoid acute renal failure. It is important to reduce the dosage of acyclovir as the serum creatinine level stabilizes.
The risk of transmission to the newborn is lower for infants whose mothers have a history of recurrent genital herpes during the first half of pregnancy. Elective cesarean delivery is recommended for women with a history of recurrent herpes. It is also recommended to use surgical masks to cover orolabial lesions while caring for the infant.
Newborns born to women with a history of the recurrent genital disease should have HSV surface cultures and PCR testing. In addition, some experts recommend repeat testing on all neonates with CNS disease.
Symptoms
Symptoms of neonatal herpes can include irritability, fever, and seizure-like activity. Affected babies may have lesions of the skin, mouth, and eyes. In some cases, neonatal herpes can progress to encephalitis and meningitis. The infection may result in death if it is not treated.
Infected infants can be diagnosed by using routine bacterial and viral cultures. These include sputum, blood, and urine specimens. The doctor may also administer an IV drip of medication to the baby. These medications include antiviral drugs that are given directly into the baby’s vein. Antiviral drugs may also be excreted in breast milk.
In addition, the doctor may perform a Tzanck smear. The smear is not specific, but it will show nuclear inclusions. This is a highly operator-dependent test and can be helpful in determining the extent of the disease.
Laboratory studies may also indicate abnormalities in liver function. The CSF of an infected infant is often elevated in red cells. This is an indication that the disease is disseminated. It is important to determine the extent of the infection and whether the disease has spread throughout the body.
A direct fluorescent antibody study is helpful in establishing a neonatal herpes diagnosis. The sensitivity is high, and the results are readily available.
Other potential indicators of neonatal herpes include abnormal movements and lethargy. These may occur before or during skin lesions. If your infant has lethargy, make sure that the baby is eating and drinking well. If the infant does not feed well, discuss it with the doctor.
Symptoms of neonatal herpes often appear in the first few days of life. However, some babies develop the disease much later, up to six weeks after birth. These babies can also develop symptoms such as seizures and meningitis.
Most babies with neonatal herpes do not become severely ill. However, not all infants will respond well to treatment. If your baby does have lethargy and/or a rash, the doctor may recommend treating him with antiviral medicines. The baby may be placed on an IV drip to prevent the virus from spreading throughout the body.
Treatment
Among the common infections that occur during pregnancy, neonatal herpes is a particularly serious condition. Neonatal herpes can cause death in infants. It is important to know how to treat neonatal herpes so that you can save the life of your baby.
In most cases, neonatal herpes infection is caused by the Herpes Simplex Virus. HSV infections are highly contagious, so it is important to treat it quickly. Some simple precautions, such as washing your hands frequently, can help to reduce the risk of spreading the disease. In addition, you should avoid kissing your newborn, as this could lead to the spread of herpes.
If your baby develops an HSV rash, you should tell your doctor. Usually, the disease becomes evident within 15 to 17 days after birth. Some infants make a full recovery if the infection is caught early.
When a neonate is diagnosed with neonatal herpes, treatment should be given immediately. Currently, the recommended treatment is to give systemic acyclovir to the baby. This medication should be given intravenously every eight hours for a total of 21 days. If your baby develops disseminated disease, you should give him/her acyclovir in addition to the systemic dose. Acyclovir is a potent antiviral drug and has been proven to reduce the rate of death.
Acyclovir is also helpful in preventing recurrent episodes of genital herpes. However, there is an increased risk of transmission from the mother to her infant. Hence, daily suppressive antiviral therapy has been recommended for all pregnant women who have recurrent herpes during the first half of pregnancy.
In the third trimester, neonates have the highest risk for neonatal herpes. The best way to prevent this is to avoid genital herpes during pregnancy. However, if you cannot avoid genital herpes, you can prevent it from reoccurring by taking oral valacyclovir.
Neonatal herpes can also affect the central nervous system and may result in encephalitis. When this happens, the infant may have brain damage, which can result in permanent disability. A lumbar puncture should be performed to check for clearance. In addition, a chest x-ray may be helpful.
CNS involvement
During the first two weeks after birth, newborn babies can develop neurologic diseases due to viral infections. These infections can involve the brain and the central nervous system. In addition, viral encephalitides can also affect the skin, eyes, and mouth. In most cases, children with neurologic diseases exhibit progressive deficits. Some common symptoms of this illness include fever, headache, lethargy, and irritability.
Herpes simplex virus (HSV) is a family of human viruses that causes various neurologic disorders. The virus is transmitted to infants by direct contact with infected secretions. Its incidence varies widely throughout the world. A newborn is most likely to be infected when the mother has primary genital herpes during delivery. Alternatively, the mother’s infection could be transmitted to the fetus through transplacental transmission.
Usually, the disease is localized to the eyes, mouth, or skin, with the eyes and mouth being the first sites of infection. However, some infants develop symptoms of viral encephalitides such as seizures, headache, and fever.
In some cases, the virus can cause cranial neuritis, cerebellar gray matter damage, or optic nerve inflammation. In addition, children with viral encephalitides may develop rashes on the skin. Some children may also have dendritic eye ulcers. Other symptoms include fever, lethargy, and poor feeding.
Neonatal herpes simplex infection is a highly morbid condition that continues to scour newborns. Early detection of the disease is important for improving outcomes. Early antiviral therapy is also important in minimizing damage to the central nervous system.
Infants with neonatal herpes simplex infection should be treated with parenteral acyclovir 20 mg kg-1 every eight hours. In addition, granulocyte colony-stimulating factors should be administered in cases where the ANC is low. The duration of treatment depends on the extent of the disease. Currently, vidarabine is the preferred antiviral for neonatal herpes. Vidarabine is an adenine arabinoside that is given as a continuous infusion.
Infants with HSV may also develop other complications such as viremia, hepatitis, or fever. These infants should be monitored closely for fever and other symptoms. If the infant has a poor renal function, nephrotoxicity may be a significant side effect.
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