Infantile Herpes Simplex Virus Meningitis: A Case Report
Background: Herpes simplex virus (HSV) is one of the main causes of neonatal meningitis; nonetheless, it usually goes unreported. A lumbar puncture is needed to accurately differentiate between viral and bacterial meningitis. The cerebrospinal fluid can be analyzed to exclude bacterial meningitis; n...
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Mashhad University of Medical Sciences
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doaj-476488dad6f74465b446e4196744531b2021-08-02T21:15:52ZengMashhad University of Medical SciencesIranian Journal of Neonatology2251-75102322-21582021-01-01121899510.22038/ijn.2020.49825.187917094Infantile Herpes Simplex Virus Meningitis: A Case ReportEzzat Khodashenas0Reza Saeidi1Neda Fakhr Ghasemi2Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranNeonatal Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranDepartment of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranBackground: Herpes simplex virus (HSV) is one of the main causes of neonatal meningitis; nonetheless, it usually goes unreported. A lumbar puncture is needed to accurately differentiate between viral and bacterial meningitis. The cerebrospinal fluid can be analyzed to exclude bacterial meningitis; nevertheless, the identification of the specific viral cause may be beneficial. Viral diagnosis determines prognosis, improves the care of the patient, decreases hospitalization duration, and reduces unnecessary use of antibiotics. In young infants, the herpes simplex virus infection is responsible for serious complications leading to morbidity, mortality, and permanent sequelae in survivors. The clinical findings of this infection usually include tremors, seizures, lethargy, irritability, poor feeding, temperature instability, and a bulging anterior fontanel, which are common in almost all forms of meningitis. These similarities make the differential diagnosis rather difficult. Case report: We report and discuss the case of an an11-day-old neonate girl who presented with fever and negative test results, as well as our challenges that finally led to the diagnosis of HSV-related meningitis and its management. Conclusion: It could be managed to reach a firm diagnosis confirming the initial differential diagnosis through additional and repetitive testing. Therefore, it is concluded that clinical judgments may be more reliable than paraclinical results in the individual approach for each patient. Furthermore, HSV infection should also be considered for patients with a persistent fever of unknown origin. It is also recommended to adopt separate procedures for the suspicion of HSV type 1 and HSV type 2. Keywords: Herpes simplex virus, Infantile fever, Meningitishttps://ijn.mums.ac.ir/article_17094_bc70c28111681f6695af213bbb03ab67.pdfinfantile feverherpes simplex virusmeningitis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ezzat Khodashenas Reza Saeidi Neda Fakhr Ghasemi |
spellingShingle |
Ezzat Khodashenas Reza Saeidi Neda Fakhr Ghasemi Infantile Herpes Simplex Virus Meningitis: A Case Report Iranian Journal of Neonatology infantile fever herpes simplex virus meningitis |
author_facet |
Ezzat Khodashenas Reza Saeidi Neda Fakhr Ghasemi |
author_sort |
Ezzat Khodashenas |
title |
Infantile Herpes Simplex Virus Meningitis: A Case Report |
title_short |
Infantile Herpes Simplex Virus Meningitis: A Case Report |
title_full |
Infantile Herpes Simplex Virus Meningitis: A Case Report |
title_fullStr |
Infantile Herpes Simplex Virus Meningitis: A Case Report |
title_full_unstemmed |
Infantile Herpes Simplex Virus Meningitis: A Case Report |
title_sort |
infantile herpes simplex virus meningitis: a case report |
publisher |
Mashhad University of Medical Sciences |
series |
Iranian Journal of Neonatology |
issn |
2251-7510 2322-2158 |
publishDate |
2021-01-01 |
description |
Background: Herpes simplex virus (HSV) is one of the main causes of neonatal meningitis; nonetheless, it usually goes unreported. A lumbar puncture is needed to accurately differentiate between viral and bacterial meningitis. The cerebrospinal fluid can be analyzed to exclude bacterial meningitis; nevertheless, the identification of the specific viral cause may be beneficial. Viral diagnosis determines prognosis, improves the care of the patient, decreases hospitalization duration, and reduces unnecessary use of antibiotics. In young infants, the herpes simplex virus infection is responsible for serious complications leading to morbidity, mortality, and permanent sequelae in survivors. The clinical findings of this infection usually include tremors, seizures, lethargy, irritability, poor feeding, temperature instability, and a bulging anterior fontanel, which are common in almost all forms of meningitis. These similarities make the differential diagnosis rather difficult.
Case report: We report and discuss the case of an an11-day-old neonate girl who presented with fever and negative test results, as well as our challenges that finally led to the diagnosis of HSV-related meningitis and its management.
Conclusion: It could be managed to reach a firm diagnosis confirming the initial differential diagnosis through additional and repetitive testing. Therefore, it is concluded that clinical judgments may be more reliable than paraclinical results in the individual approach for each patient. Furthermore, HSV infection should also be considered for patients with a persistent fever of unknown origin. It is also recommended to adopt separate procedures for the suspicion of HSV type 1 and HSV type 2.
Keywords: Herpes simplex virus, Infantile fever, Meningitis |
topic |
infantile fever herpes simplex virus meningitis |
url |
https://ijn.mums.ac.ir/article_17094_bc70c28111681f6695af213bbb03ab67.pdf |
work_keys_str_mv |
AT ezzatkhodashenas infantileherpessimplexvirusmeningitisacasereport AT rezasaeidi infantileherpessimplexvirusmeningitisacasereport AT nedafakhrghasemi infantileherpessimplexvirusmeningitisacasereport |
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