Neonatal HSV infection most commonly presents as which localized infection?

Neonatal HSV infection most commonly presents as which localized infection?

• A. Skin, eyes, or mouth
• B. Lungs and airways
• C. Disseminated CNS disease
• D. Gastrointestinal infection

Answer: (A)

Neonatal HSV most often shows up as mucocutaneous disease affecting the skin, eyes, and mouth. This form arises when the virus is transmitted during birth and initially replicates at epithelial surfaces, leading to vesicular lesions on the face, trunk, mouth, or eyes. It’s the most common presentation because, although HSV can spread to the CNS or disseminate to multiple organs, those broader, more severe forms occur less frequently as the initial manifestation. Think of SEM disease as the typical, localized entry site for neonatal HSV, with systemic disease or CNS involvement representing less common, more severe trajectories that can develop if the infection isn’t recognized and treated promptly. Early signs are often vesicles on the skin or mucosa, sometimes accompanied by fever or poor feeding, and diagnosis is supported by testing vesicular fluid or CSF with PCR while treatment with IV acyclovir should start promptly.

Neonatal HSV most often shows up as mucocutaneous disease affecting the skin, eyes, and mouth. This form arises when the virus is transmitted during birth and initially replicates at epithelial surfaces, leading to vesicular lesions on the face, trunk, mouth, or eyes. It’s the most common presentation because, although HSV can spread to the CNS or disseminate to multiple organs, those broader, more severe forms occur less frequently as the initial manifestation. Think of SEM disease as the typical, localized entry site for neonatal HSV, with systemic disease or CNS involvement representing less common, more severe trajectories that can develop if the infection isn’t recognized and treated promptly. Early signs are often vesicles on the skin or mucosa, sometimes accompanied by fever or poor feeding, and diagnosis is supported by testing vesicular fluid or CSF with PCR while treatment with IV acyclovir should start promptly.