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Mortality from neonatal herpes simplex viremia causing severe hepatitis
Journal article   Peer reviewed

Mortality from neonatal herpes simplex viremia causing severe hepatitis

Janet M Basinger, Steven E Fiester and James W Fulcher
Forensic science, medicine, and pathology, Vol.15(4), pp.663-666
12-01-2019
PMID: 31347030

Abstract

Female Hepatitis, Viral, Human - diagnosis Hepatitis, Viral, Human - virology Herpes Simplex - complications Herpes Simplex - diagnosis Humans Infant, Newborn Liver Failure, Acute - virology Male Pregnancy Pregnancy Complications, Infectious - diagnosis Viremia
Neonatal herpes simplex viral infections are rare in the setting of appropriate prenatal care; however, under circumstances where prenatal care is not delivered, these infections can lead to significant disease. We report a fatal case of herpes simplex virus with severe herpes hepatitis in a 14-day old male neonate. The clinical history was limited and nonspecific, however there was no prenatal care and a known history of drug abuse in the family. Autopsy revealed extensive necrosis and hemorrhage of the liver and cerebellum. Histologically, the liver revealed viral intranuclear ground glass inclusions, characteristic of herpes virus. Immunohistochemistry for herpes simplex virus performed on the both the liver and cerebellum showed strong diffuse staining in the liver and negative staining in the cerebellum. Neonatal herpes simplex virus infection is a disease of low prevalence with significant morbidity and mortality, and an exceptionally high rate of fatality in those with disseminated disease with associated fulminant hepatic failure.

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