Neonatal herpes simplex virus type-1 central nervous system disease with acute retinal necrosis

Pediatr Infect Dis J. 2014 Apr;33(4):424-6. doi: 10.1097/INF.0000000000000137.


We report a case of neonatal herpes simplex virus (HSV)-1 central nervous system disease with bilateral acute retinal necrosis (ARN). An infant was presented at 17 days of age with focal seizures. Cerebrospinal fluid polymerase chain reaction was positive for HSV-1 and brain magnetic resonance imaging showed cerebritis. While receiving intravenous acyclovir therapy, the infant developed ARN with vitreous fluid polymerase chain reaction positive for HSV-1 necessitating intravitreal foscarnet therapy. This is the first reported neonatal ARN secondary to HSV-1 and the first ARN case presenting without external ocular or cutaneous signs. Our report highlights that infants with neonatal HSV central nervous system disease should undergo a thorough ophthalmological evaluation to facilitate prompt diagnosis and immediate treatment of this rapidly progressive sight-threatening disease.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antiviral Agents / therapeutic use
  • Central Nervous System Diseases / drug therapy
  • Central Nervous System Diseases / pathology*
  • Central Nervous System Diseases / virology
  • Female
  • Herpes Simplex / drug therapy
  • Herpes Simplex / pathology*
  • Herpes Simplex / virology
  • Herpesvirus 1, Human / isolation & purification*
  • Humans
  • Infant, Newborn
  • Pregnancy Complications, Infectious / drug therapy
  • Pregnancy Complications, Infectious / pathology*
  • Pregnancy Complications, Infectious / virology
  • Retinal Necrosis Syndrome, Acute / pathology*
  • Retinal Necrosis Syndrome, Acute / virology


  • Antiviral Agents

Supplementary concepts

  • Neonatal herpes