Pitfalls in the diagnosis of neonatal herpes infection and learning from our mistake/a report of a case of disseminated neonatal herpes simplex with treatment failure

Introduction Herpes Simplex Virus (HSV) infection is a serious neonatal infection with high mortality and morbidity. The fact that it has a relatively low prevalence in neonates, it may not be considered early as a differential diagnosis of neonatal sepsis. A high index of suspicion is necessary for an early diagnosis and an introduction of antiviral therapy should be considered to improve the outcome. Method Case report. Results We report a case of neonatal herpes who presented with apneas, poor feeding and temperature instability on day 5. She was born at term by elective section in good condition with no maternal risk factor for infection, who was discharged home on day 3. On admission, she looked pale, was floppy with temperature of 35.5 C, HR of 140/min, RR of 18/min and CRT of 3 s. She had frequent episodes of apneas. An infection screen was performed. She received broad spectrum antibiotics. She was commenced on CPAP. Investigations showed normal glucose and electrolytes, CRP of 16 (normal