Diagnosis of Neonatal Herpes Simplex Infection from the Placenta

Due to a high rate of fetal demise and premature birth in intrauterine HSV infection, the outcome in neonates is usually adverse. A female preterm infant with a gestational age of 25 1/7 weeks with expected early clinical course tested positive for neonatal herpes simplex virus (HSV) 2 after the neo...

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Main Authors: Amanda E. Smith, Amy McKenney, Laura Rabinowitz, Anirudha Das
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Case Reports in Pediatrics
Online Access:http://dx.doi.org/10.1155/2020/8898612
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author Amanda E. Smith
Amy McKenney
Laura Rabinowitz
Anirudha Das
author_facet Amanda E. Smith
Amy McKenney
Laura Rabinowitz
Anirudha Das
author_sort Amanda E. Smith
collection DOAJ
description Due to a high rate of fetal demise and premature birth in intrauterine HSV infection, the outcome in neonates is usually adverse. A female preterm infant with a gestational age of 25 1/7 weeks with expected early clinical course tested positive for neonatal herpes simplex virus (HSV) 2 after the neonatologist was informed of positive immunohistochemistry for the virus on the fifth day of life by the pathologist. Pathological examination of the placenta had revealed subacute necrotizing inflammation with stromal cell necrosis suggestive of intrauterine infection, possibly ascending due to prolonged rupture of membranes. To the best of our knowledge, this is the first case wherein placental pathology indicated exposure to HSV in utero before the infant presented with signs or symptoms of neonatal HSV resulting in a favorable outcome for the infant. Due to the variability of presentation of intrauterine HSV infection, pathological examination of the placenta in the first 2–5 days of life in premature infants can provide clues to the diagnosis of neonatal HSV which may significantly impact the outcome.
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spelling doaj-art-08a9a22d05094855b4bb975a8b30eb962025-08-20T02:03:20ZengWileyCase Reports in Pediatrics2090-68032090-68112020-01-01202010.1155/2020/88986128898612Diagnosis of Neonatal Herpes Simplex Infection from the PlacentaAmanda E. Smith0Amy McKenney1Laura Rabinowitz2Anirudha Das3Department of Neonatology, Cleveland Clinic Children’s Hospital, Cleveland, OH, USADepartment of Pathology, Cleveland Clinic Foundation, Cleveland, OH, USADepartment of Pathology, Cleveland Clinic Foundation, Cleveland, OH, USADepartment of Neonatology, Cleveland Clinic Children’s Hospital, Cleveland, OH, USADue to a high rate of fetal demise and premature birth in intrauterine HSV infection, the outcome in neonates is usually adverse. A female preterm infant with a gestational age of 25 1/7 weeks with expected early clinical course tested positive for neonatal herpes simplex virus (HSV) 2 after the neonatologist was informed of positive immunohistochemistry for the virus on the fifth day of life by the pathologist. Pathological examination of the placenta had revealed subacute necrotizing inflammation with stromal cell necrosis suggestive of intrauterine infection, possibly ascending due to prolonged rupture of membranes. To the best of our knowledge, this is the first case wherein placental pathology indicated exposure to HSV in utero before the infant presented with signs or symptoms of neonatal HSV resulting in a favorable outcome for the infant. Due to the variability of presentation of intrauterine HSV infection, pathological examination of the placenta in the first 2–5 days of life in premature infants can provide clues to the diagnosis of neonatal HSV which may significantly impact the outcome.http://dx.doi.org/10.1155/2020/8898612
spellingShingle Amanda E. Smith
Amy McKenney
Laura Rabinowitz
Anirudha Das
Diagnosis of Neonatal Herpes Simplex Infection from the Placenta
Case Reports in Pediatrics
title Diagnosis of Neonatal Herpes Simplex Infection from the Placenta
title_full Diagnosis of Neonatal Herpes Simplex Infection from the Placenta
title_fullStr Diagnosis of Neonatal Herpes Simplex Infection from the Placenta
title_full_unstemmed Diagnosis of Neonatal Herpes Simplex Infection from the Placenta
title_short Diagnosis of Neonatal Herpes Simplex Infection from the Placenta
title_sort diagnosis of neonatal herpes simplex infection from the placenta
url http://dx.doi.org/10.1155/2020/8898612
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