Birth-acquired herpes is a herpes virus infection that an infant gets (acquires) at the time of birth.

Newborn infants can become infected with herpes virus:

• In the uterus (intrauterine herpes -- this is very rare)
• Passing through the birth canal (birth-acquired herpes, the most common method of infection)
• Right after birth (postpartum)

If the mother has an active genital herpes infection at the time of delivery, the infant is more likely to become infected during the birthing process. It is possible for a mother with a first-time (primary) herpes infection to pass the virus to her child during birth.

In addition, some people have had herpes infections in the past, but have not been diagnosed or treated. These people, not knowing that they have it themselves, may pass herpes on to their child. Herpes type 2 (genital herpes) is the most common cause of herpes infection in newborn babies, but herpes type 1 can also occur.

Intrauterine herpes can cause:

• Eye disease, such as inflammation of the retina (chorioretinitis)
• Severe brain damage
• Skin lesions

Birth-acquired herpes can produce localized or systemic (throughout the body) disease. Infants may develop only a localized skin infection consisting of small fluid-filled blisters (vesicles) that rupture, crust over, and finally heal, often leaving a mild scar.

A second type of birth-acquired herpes infection leads to encephalitis, an inflammation of the brain that can result in seizures and later brain and nervous system (neurologic) problems. If untreated, it may lead to death.

Disseminated herpes infection is the most dangerous type. In this type, the herpes virus can affect many different internal organs including the liver, lungs, kidneys, and brain. There may or may not be vesicles on the skin. This type of infection is often fatal.

Herpes acquired in the period shortly after birth has symptoms similar to birth-acquired herpes.

Symptoms of birth-acquired herpes include:

• Bleeding easily
• Breathing difficulties
  • Blue appearance (cyanosis)
  • Flaring of the nostrils
  • Grunting
  • Rapid breathing (tachypnea)
  • Short periods without breathing (apneic episodes)
• Coma
• Enlarged liver and spleen
• Jaundice
• Kidney failure
• Lethargy
• Poor feeding
• Seizures
• Shock
• Skin lesions, fluid filled blisters
• Stress or anxiety

Tests:

• Blood gas analysis
• Coagulation studies (PT, PTT)
• Complete blood count
• CT scan of the head
• DFA test for herpes (scraping from vesicle)
• Electrolyte measurements
• MRI of the head
• Spinal fluid culture
• Swab culture (from nose, throat, or rectum)
• Tests of liver function
• Urine culture
• Vesicle culture