In this case report we describe a fatal intrauterine HSV-2 infection in a mother with insulin-dependent diabetes mellitus without signs, symptoms or serological evidence of infection with this virus during pregnancy. A normally developed infant was delivered by caesarean section and the course of the viral infection was rapid and fatal within the first d. Histopathology demonstrated disseminated intravascular coagulation in several organs. The diagnosis was confirmed by PCR amplifications of HSV-2 DNA from several organs of the child at autopsy and further supported by DNA sequencing of the viral amplicon derived from brain. Despite a significant IgG titre rise to a type-common HSV IgG antigen being seen in the mother, no IgG response to the HSV-2 type-specific glycoprotein G (gG) could be documented during long-term follow-up.
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