Abstract
Neonatal herpes simplex virus (HSV) encephalitis is a rare disease nowadays because of prenatal screening test and management. It shows progressive central nervous system manifestations affecting predominantly temporal and frontal lobes. Early diagnosis of HSV encephalitis is important since even with the early initiation of high-dose intravenous acyclovir therapy, it results in serious morbidity among survivors. A 14-day-old neonate with fever and poor oral intake was admitted via emergency department. The next day she had seizures and the brain was damaged with permanent sequelae despite of early administration of intravenous acyclovir on day 2 of admission. We report a serious case of HSV encephalitis diagnosed as type 2 HSV by polymerase chain reaction and culture of a newborn without proper prenatal screening test.
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Fig. 1.
(A) T2-weighted axial images through basal ganglia on hospital day 3, showed no abnormal enhancement. (B) T2-weighted axial images through basal ganglia on hospital day 5, showed generalized increased signal. (C) Diffusion-weighted axial images through basal ganglia on hospital day 5, showed diffuse high signal intensity.
![kjp-25-195-f1.tif](/upload/SynapseXML/0044kjp/thumb/kjp-25-195-f1.gif)
Fig. 2.
At T2-weighted axial images through basal ganglia (A) on hospital day 11, there were multifocal hemorrhages, enlarged ventricles. (B) On hospital day 26, there were marked and diffuse brain atrophy with encephalomalacia of brain. (C) Six months later after discharge, there were more progressed brain atrophy with marked encephalomalacia of entire brain.
![kjp-25-195-f2.tif](/upload/SynapseXML/0044kjp/thumb/kjp-25-195-f2.gif)
Table 1.
Cerebrospinal fluid analysis and virus examinations