Child health · UKMLA & AKT
Neonatal herpes simplex virus infection
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- Presents within first 4 weeks of life - timing varies by disease category
- SEM disease (skin, eye, mouth) - vesicular skin lesions (scalp/presenting part), conjunctivitis, oral ulcers
- CNS disease - seizures, lethargy, bulging fontanelle, temperature instability; onset 2nd-4th week
- Disseminated disease - sepsis-like syndrome: fever/hypothermia, respiratory distress, hepatitis (jaundice, coagulopathy), haemodynamic instability; onset end of 1st to 2nd week
Skin vesicles are absent in up to 60% of disseminated disease - presentation is clinically indistinguishable from bacterial sepsis. Do not wait for vesicles before considering HSV in an unwell neonate.
~70% of neonatal HSV infections arise from mothers with NO known history of genital herpes - a clear maternal history cannot rule out risk.
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