Herpes sepsis of the newborn

Last Updated: 2023-07-07

Author(s): Anzengruber F., Navarini A.

ICD11: -

Frequently life-threatening initial herpes infection (in 75% HSV type II, increasingly also HSV I) in newborns and premature babies. In 70% of cases, the genital HSV type II recurrence in the mother is asymptomatic.

  • Incidence: 1:3000-10000 births
  • Incubation period: 2-6 days
  • Mostly infection in the birth canal
  • 10-15% infection from non-genital herpes lesions
  • Diaplacental infection before 20 weeks' gestation usually leads to abortion
  • Frequently severe course, as HSV encounter an immunologically immature organism (only small amount of antiretroviral cytokines)

Symptomatology in the early phase is often non-specific and without vesicular efflorescences. 1/3 of the newborns have generalised exanthema with herpes simplex vesicles on the skin, 1/3 show herpes vesicles only belatedly and 1/3 of the newborns remain free of skin symptoms. Aphthous mucosal changes in the sense of gingivostomatitis herpetica, reduced AZ, dyspnoea, loss of appetite, fever or hypothermia, hepatosplenomegaly, dyspepsia, icterus, bleeding tendency, keratoconjunctivitis herpetica, retroflexion of the head as a typical sign of encephalitis (meningismus, meningoencephalitis).


  • High lethality (approx. 50-60% in the first week), 20-25% with permanent cerebral disorders
  • Neither in the delivery room nor in a premature infant ward should people with a herpes infection be allowed
  • Transmission rate: 40-60% infection in mother with active herpes infection

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