Diagnosis and treatment of herpes simplex virus (HSV) infection in the newborn

Neonatal herpes simplex virus (HSV) disease is a rare but sometimes highly lethal infection. The reported incidence in Australia is approximately four cases per 100,000 live births (1). HSV type 2 (HSV-2) is the predominant serotype that causes infection in the newborn in the United States 2, whereas in Australia 1 neonatal infection is usually caused by HSV type 1 (HSV-1), most likely due to greater prevalence of oral and genital HSV-1 disease in this country (3). Diagnosis of neonatal infection requires a high index of clinical suspicion as signs are non-specific, and is usually confirmed by isolation of HSV from skin vesicle or detection of HSV DNA in the cerebrospinal fluid, blood or surface swab. Treatment requires intravenous aciclovir for 14-21 days depending on the form of disease.