Child health · UKMLA & AKT
Neonatal herpes simplex virus infection
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise neonatal herpes simplex virus infection — the full SA Note notes add investigations, management, complications and 10 practice questions.
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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