Disseminated Herpes Infection

Female doctor examining newborn baby in incubator. Blend Images - ERproductions Ltd / Brand X Pictures / Getty Images

Most herpes infections only cause local problems. In fact, the majority cause no noticeable symptoms at all. However, in rare, cases herpes can cause full body illness. This is referred to as disseminated herpes. Disseminated diseases are diseases that are spread throughout the body. 

Disseminated herpes is most commonly seen as a complication of neonatal herpes. Neonatal herpes infections generally occur when a baby is exposed to the virus during pregnancy or at the time of birth.

However, disseminated infections can also occur in adults. A disseminated herpes infection may appear simply as lesions at multiple skin sites. That is not always an emergency. Such infections are considerably more severe when the infection spreads to the central nervous system. The central nervous system includes the spinal cord and the brain. 

When herpes infects the central nervous system (CNS), it can cause encephalitis or meningitis. Encephalitis is swelling of the brain. Meningitis is swelling of the protective layers of the brain and spinal cord. Left untreated, disseminated herpes infections that affect the CNS have high fatality rates. Fortunately, mortality and long term complications can be reduced by prompt treatment with acyclovir. That drug may sound familiar, since it is also used to treat herpes infections more generally. 

Disseminated herpes infection can be detected by using PCR.

This molecular test can look for herpes viruses in fluid from the spinal cord. However, this type of testing can lead to false negatives. Therefore, since a lack of prompt treatment can be fatal, many doctors will presumptively treat with acyclovir based on a patient's symptoms. In other words, they'll treat whether or not the person tests positive, if they are known to have herpes and have symptoms of a CNS infection.

This can be done, because acyclovir is a relatively safe drug. Symptoms of CNS herpes may include headache, vomiting, and other neurological signs.

Infants with disseminated herpes infections usually begin to show symptoms within 5-9 days after birth. These symptoms may include seizures, trouble breathing, irritability, and jaundice. Disseminated herpes in infants has a mortality rate of 85 percent if the infection remains untreated. Unfortunately, even prompt treatment is not a guarantee of symptom free survival. Many infants experience neurological problems after treatment However, prompt appropriate treatment makes a big difference in infants' outcomes after infection. . 

Disseminated herpes infections can be caused by varicella zoster virus and other human herpes viruses. It's not only caused by the herpes simplex viruses that cause genital and oral infections. In all cases, disseminated infections may be more likely to occur in immunocompromised individuals, such as those with advanced AIDS

Did You Know: Most cases of neonatal herpes infection occur at the time of delivery. Women are most at risk of passing on a herpes infection to their infant if they became infected during pregnancy or have active lesions at the time of delivery. That's why it's important to have safe sex - including safe oral sex - while pregnant. In addition, if you become infected, suppressive treatment near the time of delivery may be recommended. Many doctors also recommend a c-section when women have vaginal lesions at the time she is giving birth. 


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