Neonatal herpes simplex virus infections: HSV DNA in cerebrospinal fluid and serum
G Malma, M Forsgrenb
a Department of
Paediatrics B68 Huddinge University Hospital
Karolinska Institute
14186 Huddinge SE-1
Sweden, b Division of Clinical
Virology F68
Correspondence to: Dr Gunilla Malm.
Accepted 15 February
1999
AIM
To investigate the
diagnostic potential of herpes simplex virus (HSV) DNA in cerebrospinal
fluid and serum; to correlate the findings with outcome in the child
and with type of maternal infection.
METHODSCerebrospinal
fluid and serum specimens from 36 children with verified neonatal HSV
infections, diagnosed between 1973 and 1996, were examined using the
polymerase chain reaction technique (PCR).
RESULTSIn 21 children
for whom both cerebrospinal fluid and sera were available, HSV DNA was
found in one or both specimens in 19 (90%). Overall, HSV DNA was found
in the cerebrospinal fluid of 74% of 27 children, and in the sera of
20 out of 30 children (67%). In two children HSV DNA was not
demonstrable in either serum or cerebrospinal fluid. In sequential
specimens from four children, the persistence of HSV DNA after the end
of intravenous treatment was associated with a poor prognosis.
CONCLUSIONSThese
findings indicate that HSV DNA detection in CSF and serum is highly
sensitive for the diagnosis of neonatal HSV infections but does not
replace the detection of virus in other locations using virus isolation
and antigen detection.
Keywords: HSV DNA; herpes simplex virus infections; PCR
© 1999 by Archives of Disease in Childhood
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