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Neonatal Infections

»	What are the TORCHES infections in a neonate?
»	Describe the cutaneous findings in neonatal herpes simplex viral (HSV) infections.
»	Is neonatal herpes simplex dangerous?
»	What percentage of herpes-infected neonates display skin or mucosal lesions?
»	What percentage of these lesions are HSV-1, as opposed to HSV-2?
»	What tests can be done to diagnose herpes infections? How should material be obtained for these tests?
»	What is congenital varicella syndrome?
»	What is the average age of onset of lesions in a neonate exposed to varicella perinatally? When is there an increased risk of mortality?
»	What is the treatment of neonatal HSV and varicella infection?
»	What is a “blueberry muffin baby”? What is the significance of this diagnosis?
»	At what time during pregnancy is there the highest risk of congenital rubella following maternal infection?
»	List the classic triad of congenital rubella syndrome (CRS).
»	Are any precautions necessary for infants with congenital rubella syndrome at the time of hospital discharge?
»	Why is human parvovirus infection important to a pregnant woman?
»	Are most infants with congenital cytomegalovirus (CMV) infection symptomatic?
»	What cutaneous findings are seen in congenital CMV infection?
»	What clinical findings are seen in congenital Epstein-Barr virus infection?
»	Describe a clinical presentation of congenital human papillomavirus infection.
»	What is the risk of HIV infection transmission to an infant born from an HIV-positive mother?
»	What is Hutchinson’s triad?
»	Are there any other stigmata of late congenital syphilis?
»	What are the physical findings of early congenital syphilis?

Describe the cutaneous findings in neonatal herpes simplex viral (HSV) infections.

Fig. 57.1 A, Congenital herpes simplex virus infection. B, Congenital mucosal herpes simplex virus infection. (Courtesy of William L. Weston, MD.)

HSV infection usually presents as grouped vesicles on an erythematous base. These lesions can be present on any part of the skin but are more common on the face, scalp, or buttocks (Fig. 57-1). They may also be generalized or disseminated or occur in the perianal region in a breech-delivered baby. In the intrauterine-exposed baby, they may present as atrophic areas with scarring.

Corey L, Wald A: Maternal and neonatal herpes simplex virus infections, N Engl J Med 361:1376–1385, 2009.