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Israeli neonatal herpes simplex infection: Unique epidemiology and clinical profile. | LitMetric

AI Article Synopsis

  • A study conducted on Israeli neonatal herpes simplex virus (NHSV) infection collected data from 2015 to 2022, comparing clinical characteristics of NHSV patients with those suffering from neonatal enteroviral meningitis (NEM).
  • The results showed an NHSV incidence of 5.9 per 100,000 live births, with notable demographics suggesting that horizontal transmission was linked to practices like ritual circumcision.
  • NHSV patients presented unique symptoms such as a lower incidence of fever and irritability but showed a tendency for rashes and seizures, marking a distinct clinical profile compared to NEM, which can help guide treatment approaches for infected newborns.

Article Abstract

To gather national level data on Israeli neonatal HSV (NHSV) infection and to evaluate the distinct clinical characteristics of NHSV and neonatal enteroviral meningitis (NEM). Israeli NHSV patients, hospitalized between January 2015 and April 2022 in 22 medical centers were assessed, together with NEM patients, hospitalized at Sheba Medical Center during the same period. NHSV demographic and clinical characteristics were documented and compared to those of NEM. Eighty-five NHSV (73% males) and 130 NEM (62% males) patients were included. The incidence of NHSV was 5.9/100 000 live births, the common phenotype and HSV type were SEM (53%) and HSV1 (91%), respectively. Horizontal transmission was suspected in 50% cases (of which 67% underwent a Jewish ritual circumcision with direct wound sucking, 33% had relatives with highly suspicious herpetic lesions). Compared with NEM, NHSV tends to present with rash (14% vs. 60%, p-value < 0.01) and seizures (0% vs. 6%, p-value 0.02), while fever, irritability and poor feeding appear more frequently in NEM (94% vs. 18%, p-value < 0.01; 37% vs. 1%, p-value < 0.01; 25% vs. 1%, p-value < 0.01 respectively). Of NEM patients, 28% were treated with acyclovir. Our results mark a decrease in the incidence rate of NHSV in Israel and a prominent mode of horizontal infection acquisition. We underscore the unique localized phenotype of NHSV, in contrast to enterovirus, which tends to cause a systemic disease with constitutional symptoms. These findings should be considered when evaluating the need for comprehensive empirical treatment for HSV in the context of neonatal fever, or according to a certain clinical presentation.

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Source
http://dx.doi.org/10.1002/jmv.29934DOI Listing

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