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Mortality from neonatal herpes simplex viremia causing severe hepatitis

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Abstract

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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References

  1. Kimberlin DW. Herpes simplex virus infections of the newborn. Semin Perinatol. 2007;31:19–25.

    Article  Google Scholar 

  2. Lao S, Flagg EW, Schillinger JA. Incidence and characteristics of neonatal herpes: comparison of two population-based data sources, new York City, 2006–2015. Sex Transm Dis. 2019;46:125–31.

    Article  Google Scholar 

  3. Orekoya O, White K, Samson M, Robillard AG. The South Carolina comprehensive health education act needs to be amended. Am J Public Health. 2016;106:1950–2.

    Article  Google Scholar 

  4. Dye DW, Simmons GT. Fatal herpes virus type I infection in a newborn. Am J Forensic Med Pathol. 2010;31:89–91.

    Article  Google Scholar 

  5. Verma A, Dhawan A, Zuckerman M, Hadzic N, Baker AJ, Mieli-Vergani G. Neonatal herpes simplex virus infection presenting as acute liver failure: prevalent role of herpes simplex virus type I. J Pediatr Gastroenterol Nutr. 2006;42:282–6.

    Article  Google Scholar 

  6. Egawa H, Inomata Y, Nakayama S, Matsui A, Yamabe H, Uemoto S, et al. Fulminant hepatic failure secondary to herpes simplex virus infection in a neonate: a case report of successful treatment with liver transplantation and perioperative acyclovir. Liver Transpl Surg. 1998;4:513–5.

    Article  CAS  Google Scholar 

  7. Looker KJ, Magaret AS, May MT, Turner KM, Vickerman P, Newman LM, et al. First estimates of the global and regional incidence of neonatal herpes infection. Lancet Glob Health. 2017;5:e300–9.

    Article  Google Scholar 

  8. Nicoll J, Love S, Burton P, Berry P. Autopsy findings in two cases of neonatal herpes simplex virus infection: detection of virus by immunohistochemistry, in situ hybridization and the polymerase chain reaction. Histopathology. 1994;24:257–64.

    Article  CAS  Google Scholar 

  9. Solomon IH, Hornick JL, Laga AC. Immunohistochemistry is rarely justified for the diagnosis of viral infections. Am J Clin Pathol. 2017;147:96–104.

    Article  CAS  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, 37232, USA

    Janet M. Basinger

  2. Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC, 29605, USA

    Steven E. Fiester & James W. Fulcher

  3. Department of Pathology, Prisma Health – Upstate, Greenville, SC, 29605, USA

    Steven E. Fiester & James W. Fulcher

  4. Office of the Medical Examiner, Greenville County, SC, USA

    James W. Fulcher

  5. Pathology Associates of Greenville and Prisma Health – Upstate, Greenville, SC, 29605, USA

    James W. Fulcher

Authors
  1. Janet M. Basinger
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  2. Steven E. Fiester
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  3. James W. Fulcher
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Correspondence to Janet M. Basinger.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Informed consent in this case report in compliance with South Carolina ethical standards.

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Basinger, J.M., Fiester, S.E. & Fulcher, J.W. Mortality from neonatal herpes simplex viremia causing severe hepatitis. Forensic Sci Med Pathol 15, 663–666 (2019). https://doi.org/10.1007/s12024-019-00147-w

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  • DOI: https://doi.org/10.1007/s12024-019-00147-w

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