Herpes simplex encephalitis in newborns. Treatment with 5-iodo-2'-deoxyuridin? (author's transl)

Premature twins both affected with generalized herpes simplex infection including CNS involvement were treated with 5-Iodo-2'-deoxyuridin (IDU). Therapy was started 6 days and 5 days, respectively, after appearance of the first symptoms. Nevertheless both babies died, twin A at the age of 24 and twin B at the age of 28 days. Herpes virus was cultured from all organs in twin A. The literature shows a decrease in mortality in children treated with IDU for herpes simplex encephalitis. The percentage of survivors with ultimate severe CNS damage, however, is very high and remains in treated or untreated patients the same. The institution of IDU therapy in neonates with manifest HSV encephalitis is therefore not unequivocally justified.