单纯疱疹病毒概要1.ppt

THE FIRST AFFLIATED HOSPITAL OF GUANGXI MEDICAL UNIVERSITY DEPARTMENT OF PEDIATRICS NICU Neonatal Herpes Simplex Infection INTRODUCTION Discovery of neonatal Herpes Simplex virus (HSV) in the 1930s Neonatal infection with HSV occurs in 1/3200 to 1/10,000 live births In China，2/10,000 to 5/10,000 VIROLOGY ● HSV is a DNA virus ● HSV-I, HSV-II HSV-II associated with poorer outcome TRANSMISSION ~HSV enters human host through inoculation of oral, genital, or conjunctival mucosa or break in skin 1.Intrauterine 2. Perinatal 3. Postnatal Maternal viremia Ascending infection Usually after prolonged rupture of membranes Intrauterine 2. Perinatal -HSV infection is present in the genital tract of pregnant woman at time of delivery -Most common mode (85%) of neonatal HSV infection 3. Postnatal -When active HSV infection has close contact with the newborn intrauterine 5% perinatal 85% postnatal 10% CLINICAL MANIFESTATIONS -Skin, Eye, Mouth -Central Nervous System -Disseminated Disease 90% present between 5-19 days of age 20% NEVER have skin lesions Initial symptoms vague in 30% Lethargy Poor feeding Fever Irritability skin -Usually presents in the first two weeks of life -clustering vesicular lesions with an erythematous base Eyes- 1.Excessive watering of the eye 2.Crying from apparent eye pain 3.Conjunctival erythema 4.Periorbital skin vesicles 5.Can progress to cataracts and chorioretinitis ? permanent vision loss Mouth -Localized ulcerative lesions of the mouth, palate, and tongue CNS Disease 1/3 of neonatal HSV disease involves the CNS Presents in second-third week of life Irritability Tremors Poor feeding HERPES ENCEPHALITIS ? of HSV disease is in the disseminated form Present in the first week of life Affects: liver, lungs, adrenals, CNS, skin, eyes, and mouth,DIC Disseminated Disease Diagnosis of Neonatal HSV Infection Gold standard = Positive culture of: lesion, nasopharynx, conjunctiva, rectum, or CSF Rapid d