Herpetic sepsis of the newborn

Last Updated: 2020-07-17

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

ICD11: -

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

  • Incidence: 1:3,000-10,000 births
  • Latent period: 2-6 days
  • Mostly infection in the birth canal.
  • 10-15% infection by non-genital herpes lesions
  • A diaplacental infection before the 20th SSW usually leads to miscarriage

  • Often difficult course, as HSV meets an immunologically immature organism (only a small amount of antiretroviral cytokines)

Symptoms in the early phase are often non-specific and without vesicular efflorescences. 1/3 of newborns have generalized exanthema with herpes simplex blisters on the skin, 1/3 show herpes blisters only after a delay and 1/3 of newborns do not show any skin symptoms. Aphthous mucosal changes in the sense of gingivostomatitis herpetica, reduced AZ, dyspnoea, loss of appetite, fever or hypothermia, hepatosplenomegaly, dyspepsia, icterus, tendency to bleed, keratoconjunctivitis herpetica, retroflexion of the head as a typical sign of encephalitis (meningism, meningoencephalitis).

  • High mortality (approx. 50-60% in the first week), 20-25% with permanent cerebral disorders

  • Neither in the delivery room nor on a premature infants ward may people with a herpes infection stay

  • Transmission rate: 40-60% infection in mother with active herpes infection

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