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Neonatal herpes simplex presenting as a zosteriform eruption
  1. Elizabeth Anderson1,
  2. Emma Johns2,
  3. Joseph Conlon3,4 and
  4. Ezzeldin Saleh5
  1. 1Internal Medicine, Southern Illinois University School of Medicine, Springfield, Illinois, USA
  2. 2Department of Pediatrics, Southern Illinois University School of Medicine, Springfield, Illinois, USA
  3. 3Department of Pediatrics and Department of Dermatology, Southern Illinois University School of Medicine, Springfield, Illinois, USA
  4. 4Department of Pediatrics, Springfield Clinic, Springfield, Illinois, USA
  5. 5Pediatrics-Infectious Diseases, Southern Illinois University School of Medicine, Springfield, Illinois, USA
  1. Correspondence to Dr Ezzeldin Saleh; esaleh84{at}


Herpes simplex virus (HSV) infection in newborn infants is a potentially devastating disease leading to death and disability. Skin, eye and mouth (SEM) infections account for approximately half of the cases in the USA. The appearance of skin findings often guides clinicians towards early diagnosis of HSV infection, prompt interventions and life-saving management; however, less than half of neonates with proven disease present with characteristic vesicular lesions. Furthermore, if SEM infections are not treated promptly, there is significant risk of progression to central nervous system and disseminated disease. We present a case of HSV-2 infection in a neonate with an atypical zosteriform eruption on day 3 of life. This case demonstrates that neonatal HSV can unusually present in a zosteriform rash. By elucidating this unique presentation, we highlight atypical HSV skin presentation and emphasise on the importance of earlier diagnosis and antiviral treatment to prevent the associated morbidity and mortality.

  • neonatal and paediatric intensive care
  • infectious diseases
  • dermatology

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  • Presented at The case was presented at the Southern Illinois University School of Medicine 32nd annual trainee’s research symposium.

  • Contributors EA and EJ drafted the initial manuscript and table, collected pertinent data, and reviewed and revised the manuscript. ES provided figures. EA, EJ and ES performed the relevant literature search and review. ES and JC reviewed and revised the manuscript. ES and JC contributed to case management. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.