Research during the past 30 years has transformed our approach to the diagnosis and management of neonatal herpes simplex virus (HSV) encephalitis. Nevertheless, early diagnosis of HSV encephalitis and its long-term management continue to challenge practitioners, primarily because of the paucity of clinical symptoms and laboratory abnormalities associated with early disease.1–5  Fonseca-Aten et al, in this issue of Pediatrics, report on an infant who developed symptomatic HSV encephalitis during administration of daily oral acyclovir (ACV) given to “suppress” HSV disease. Elements of this case spotlight issues peculiar to HSV that may assist pediatric practitioners in the timely diagnosis and effective management of neonatal HSV encephalitis.1,5,7–10 

Neonatal HSV infections are often categorized into 1 of 3 syndromes: skin-eye-mouth, disseminated, and central nervous system (CNS). However, these disease patterns are not discreet, with encephalitis often due to the extension...

You do not currently have access to this content.