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The Evaluation and Treatment of an Infant Exposed to Nongenital HSV-2.
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- Author(s): Staggs, Jenna
- Source:
Advances in Neonatal Care (Lippincott Williams & Wilkins); Feb2024, Vol. 24 Issue 1, p65-70, 6p- Subject Terms:
CEREBROSPINAL fluid examination; COMMUNICABLE disease diagnosis; HERPESVIRUS diseases; BLOOD; LIVER function tests; CELL culture; INTRAVENOUS therapy; ACYCLOVIR; COMMUNICABLE diseases; INFANT care; ANTIVIRAL agents; EXANTHEMA; AUTOIMMUNE diseases; PRENATAL exposure delayed effects; IMMUNOGLOBULIN G; RISK assessment; PREGNANCY complications; POLYMERASE chain reaction; DECISION making in clinical medicine; VERTICAL transmission (Communicable diseases); DISCHARGE planning; CHILDREN; PREGNANCY - Source:
- Additional Information
- Abstract: Background: Pregnant persons with a primary genital herpes simplex virus (HSV) infection can transfer HSV to the fetus or infant through the placenta or birth canal, which can cause significant infant morbidity or mortality. Primary nongenital infections with HSV-1 or HSV-2 in pregnant persons and the risk of infant infection are not well documented, leaving the clinician to make non-evidence-based decisions on evaluation and treatment in such presentations. Clinical Findings: A term newborn was delivered vaginally by a pregnant person with a nongenital HSV-2 infection. The pregnant person's rash first appeared around 32 weeks' gestation, started on their lower back, and terminated on the outer left hip. The rash improved but was still present at time of delivery, and this rash was their first known HSV outbreak. Primary Diagnosis: Prenatal exposure to HSV-2. Interventions: Diagnostics included the pregnant person's rash surface culture, immunoglobulin G and immunoglobulin M for HSV-1 and -2; infant surface, cerebral spinal fluid (CSF), and serum HSV-1 and HSV-2 polymerase chain reactions (PCRs), infant CSF studies, blood culture, liver function tests, and treatment with intravenous acyclovir. Outcomes: This infant remained clinically well during hospitalization and was discharged home at 5 days of life when CSF, surface, and serum PCRs resulted negative. Practice Recommendations: Risk for infant HSV infection versus parent/infant separation and exposure to invasive procedures and medications should be considered when pregnant persons present with primary versus recurrent nongenital HSV infections. Research is needed for the evaluation and treatment of infants born to pregnant persons with primary nongenital HSV infections in pregnancy. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Advances in Neonatal Care (Lippincott Williams & Wilkins) is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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