TABLE 1.
Demographic, diagnostic, and clinical information for neonates with HSV diseasea
| Age (days) | Sex | Result for HCV by: |
PCR CT | Presence of: |
Other symptoms | CSF WBC (no. of cells/mm3) | CSF WBC differential (%) | Brain MRI findingc | AST/ALT (U/liter) | Duration of treatment with acyclovir (days) | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Culture of surface swabs | PCR of surface swabs | PCR of CSFb | PCR of blood | Vesicles | Fever | Apnea | Seizures | |||||||||
| 8 | M | Pos | HSV-1 | Neg | HSV-1 | 27.1 | Yes (Pos by culture) | No | No | No | 7 | 27 L, 23 Mo, 50 Ma | NT | 32/24 | 14 | |
| 15 | F | Pos | HSV-2 | Neg | HSV-2 | 18.0 | No | Yes | No | No | Liver failure | 3 | NT | 1 | 10,003/2,573 | Treated but deceased |
| 16 | M | Pos | HSV-2 | HSV-2 | HSV-2 | 22.5 | No | No | Yes | Yes | 6 | 33 N, 8 B, 27 L, 29 Mo, 3 Ma | 2 | 90/32 | 21 | |
| 16 | F | Neg | HSV-1 | Neg | HSV-1 | 35.9 | No | No | Yes | Yes | 17 | 5 N, 39 L, 35 Mo, 18 Ma | Normal | 75/29 | 21 | |
| 28 | F | Neg | HSV-1 | NT | HSV-1 | 32.9 | No | Yes | Yes | No | 2 | NT | Normal | 1,032/365 | 21 | |
| 19 | F | Neg | HSV-2 | Neg | HSV-2 | 33.5 | Yes (NT) | No | No | Yes | Retinitis | 89 | 4 N, 60 L, 34 Mo, 2 Ma | 3 | 75/29 | 21 |
| 4 | F | Neg | Neg | Neg | HSV-1 | Neg | No | No | No | Yes | Stroke | 8 | 1 N, 34 L, 65 Mo | 4 | 62/22 | 21 |
F, female; M, male; Pos, positive; Neg, negative; NT, not tested; N, neutrophils; B, bands; L, lymphocytes; Mo, monocytes; Ma, macrophages; AST, aspartate aminotransferase; ALT, alanine aminotransferase; WBC, white blood cell count; MRI, magnetic resonance imaging.
All patients with evidence of meningitis had repeat lumbar punctures prior to completion of acyclovir therapy, and all were HSV PCR negative.
Brain magnetic resonance imaging findings were classified as follows: 1, extensive diffuse restricted diffusion throughout the cerebral hemispheres and, to a lesser degree, the brain stem and cerebellum, with associated T2 hyperintensities and a loss of gray-white matter differentiation; diffuse leptomeningeal enhancement; 2, multifocal areas of restricted diffusion throughout both cerebral hemispheres; 3, extensive laminar necrosis and areas of prior cortical hemorrhage along the bilateral cerebral and cerebellar hemispheres, with scattered regions of cystic encephalomalacia, greatest in the left frontal and anterior temporal lobes; 4, deep right middle cerebral artery territory ischemia.