Guidance on Management of Asymptomatic Neonates Born to Women With Active Genital Herpes Lesions
ABSTRACT Herpes simplex virus (HSV) infection of the neonate is uncommon, but genital herpes infections in adults are very common. Thus, although treating an infant with neonatal herpes is a relatively rare occurrence, managing infants potentially exposed to HSV at the time of delivery occurs more frequently. The risk of transmitting HSV to an infant during delivery is determined in part by the mother's previous immunity to HSV. Women with primary genital HSV infections who are shedding HSV at delivery are 10 to 30 times more likely to transmit the virus to their newborn infants than are women with recurrent HSV infection who are shedding virus at delivery. With the availability of commercial serological tests that reliably can distinguish type-specific HSV antibodies, it is now possible to determine the type of maternal infection and, thus, further refine management of infants delivered to women who have active genital HSV lesions. The management algorithm presented herein uses both serological and virological studies to determine the risk of HSV transmission to the neonate who is delivered to a mother with active herpetic genital lesions and tailors management accordingly. The algorithm does not address the approach to asymptomatic neonates delivered to women with a history of genital herpes but no active lesions at delivery.
- SourceAvailable from: sciencedirect.com
[Show abstract] [Hide abstract]
- "Neonatal HSV infection is typically acquired through exposure to infected maternal genital secretions during delivery. The risk of acquiring neonatal infection is influenced by several factors, including the type of maternal infection and maternal antibody status, as well as prolonged rupture of membranes and the use of fetal scalp monitoring  . Infants born to women who have a first episode genital HSV infection near term are at a much greater risk of developing neonatal HSV infection when compared to mothers with a history of recurrent HSV infection . "
ABSTRACT: Disseminated neonatal herpes simplex virus infection usually presents with multi-organ involvement. Untreated, this disease has a mortality rate of approximately 80%. Here, we describe a well-appearing 3-week old infant with isolated compensated hepatic failure caused by HSV-2.IDCases 12/2014; 1(2):14–16. DOI:10.1016/j.idcr.2014.03.001
Article: Academy News[Show abstract] [Hide abstract]
ABSTRACT: Imagine the impact of a single substance able to reverse antibiotic resistance and to kill tumor cells without harming healthy cells. Dr. Anders Hakansson, working as a graduate student in the laboratory of Dr. Catharina Svanborg, Lund University, Sweden, was studying human milk effects on the binding of bacterial cells to epithelial cells when he noted that a specific casein fraction of human milk blocked the binding of the bacterial cells and also affected the viability of the lung cancer cells used in the experiment.1 Further research determined that the casein protein, alpha-lactalbumin, must be partially unfolded and then bound with a specific fatty acid found in human breast milk to become a substance now known as HAMLET: Human Alpha-lactalbumin Made LEthal to Tumor cells. Two major lines of research have evolved from these observations: use of HAMLET in antimicrobial activity and as a tumoricidal agent.Neonatal network: NN 07/2014; 32(4):301-8. DOI:10.1891/0730-08126.96.36.1991
- [Show abstract] [Hide abstract]
ABSTRACT: OBJECTIVE: To review the evidence describing the safety of ganciclovir and foscarnet in neonates in order to guide treatment for central nervous system or disseminated herpes simplex infections in cases of acyclovir shortage or resistance. METHODS: PubMed, Ovid Medline, and International Pharmaceutical Abstracts were searched using the thesaurus and text-word terms “ganciclovir” and “foscarnet,” with birth to 1 month age limits. Thirty-two eligible publications describing safety in neonates were identified. RESULTS: In 340 neonates treated for cytomegalovirus (CMV), life-threatening neutropenia (absolute neutrophil count <0.5 × 109/L) was reported in 8.8% of patients following up to 12 months of ganciclovir administered intravenously. Neutropenia and thrombocytopenia occurred in 25.6% and 6.2% of neonates, respectively. Changes in serum creatinine concentration of >0.2 mg/dL occurred in <1% of neonates. Hepatic transaminase increases or unspecified changes in liver function tests were reported in 6.2% of neonates with hyperbilirubinemia being observed in 3.5% of total neonates. Three out of four neonates receiving foscarnet for acyclovir-resistant herpes infection or CMV survived with minimal sequelae. Neither nephrotoxicity nor electrolyte or mineral imbalances were reported. CONCLUSIONS: Similar to what is seen in adolescents and adults, ganciclovir use in neonates is commonly associated with neutropenia, and the frequency of occurrence is comparable. The link between hepatotoxicity and ganciclovir should be interpreted with caution because of overlapping clinical manifestations of CMV. Only case reports are available describing foscarnet use in neonates, but adverse drug reactions were not observed. More research on these two agents is needed to draw conclusions about adverse drug reaction rates in the neonatal population.04/2014; 19(2):72-82. DOI:10.5863/1551-6776-19.2.72