Neonatal Intensive Care Unit, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy.
Faculty of Medicine and Surgery, "Tor Vergata" University of Rome, Rome, Italy.
J Med Virol. 2023 Aug;95(8):e29024. doi: 10.1002/jmv.29024.
This review examines the recent literature on the management of herpes simplex virus (HSV) infections in neonates. We summarized the three clinical categories of maternal HSV infection during pregnancy (primary first episode, nonprimary first episode, or recurrent episode) and the mechanisms of fetal damage. Considering when the transmission of the infection from the mother to the fetus/newborn occurs, three types of neonatal infection can be distinguished: intrauterine infection (5% of cases), postnatal infection (10% of cases), and perinatal infections (85% of cases). Neonatal presentation could range from a limited disease with skin, eye, and mouth disease to central nervous system disease or disseminated disease: the treatment with acyclovir should be tailored according to symptoms and signs of infection, and virological tests. These children need a multidisciplinary follow-up, to timely intercept any deviation from normal neurodevelopmental milestones. Prevention strategies remain a challenge, in the absence of an available vaccine against HSV.
本文综述了近期关于新生儿单纯疱疹病毒（HSV）感染管理的文献。我们总结了妊娠期间母体 HSV 感染的三种临床类型（初次原发感染、非初次原发感染或复发性感染）和胎儿损伤的机制。考虑到感染从母体向胎儿/新生儿传播的时间，可将新生儿感染分为三种类型：宫内感染（占 5%）、产后感染（占 10%）和围生期感染（占 85%）。新生儿表现可从皮肤、眼睛和口腔疾病有限的疾病到中枢神经系统疾病或播散性疾病不等：阿昔洛韦的治疗应根据感染的症状和体征以及病毒学检查来进行调整。这些儿童需要多学科的随访，以便及时发现任何偏离正常神经发育里程碑的情况。由于缺乏针对 HSV 的可用疫苗，预防策略仍然是一个挑战。
