« Back to Special Patient Populations

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?

What tests can be done to diagnose herpes infections? How should material be obtained for these tests?

To obtain specimens for diagnostic testing, scrape the base of a blister and smear the material on a microscope slide. Stain (e.g., Wright’s stain) and look for multinucleated giant cells. If available, send another slide for a HSV-fluorescein antibody test. Confirmation of a cytopathic effect can be made by immunofluorescence using antibodies specific to HSV-1 and HSV-2. Material from the blister base can be sent for viral culture. The sensitivity of performing a culture is best for a vesicular lesion. It is also advisable to culture urine, nasopharynx, conjunctiva, and cerebrospinal fluid, if indicated. The polymerase chain reaction (PCR) detects viral DNA and can be important in diagnosing HSV encephalitis.

Boyer S, Boyer K: Update on TORCH infections in the newborn infant, Newborn Infant Nurs Rev 4:70–80, 2004.