Disseminated Dz

<p>Neonates with disseminated HSV often present in the first week of life with nonspecific signs and symptoms of neonatal sepsis, including temperature dysregulation (fever or hypothermia), apnea, irritability, lethargy, and respiratory distress [2,28]. Rarely, neonates with HSV infection may present with fever alone [29]. The diagnosis of disseminated neonatal HSV disease often is delayed until the second week of life, awaiting the results of evaluation for bacterial sepsis. As disseminated neonatal HSV progresses, hepatitis with elevated liver transaminases, ascites and direct hyperbilirubinemia, neutropenia, thrombocytopenia, disseminated intravascular coagulation, hemorrhagic pneumonitis with or without effusion, necrotizing enterocolitis, and meningoencephalitis with seizures may occur [2,28]. In advanced disseminated neonatal HSV disease, fever is often absent, and hypothermia, often accompanied by respiratory failure and shock, is more prominent</p>