PT  - JOURNAL ARTICLE
AU  - Lucy Anne Fitzgerald
AU  - Diluki Kevitiyagala
AU  - Steve Gould
AU  - Stanley Zengeya
TI  - Neonatal sepsis: A, B, C–don’t ever forget herpes
AID  - 10.1136/bcr.07.2011.4423
DP  - 2011 Nov 09
TA  - BMJ Case Reports
PG  - bcr0720114423
VI  - 2011
4099  - http://casereports.bmj.com/content/2011/bcr.07.2011.4423.short
4100  - http://casereports.bmj.com/content/2011/bcr.07.2011.4423.full
AB  - A 5-day-old male presents to the emergency department septic and jaundiced, is resuscitated and started on broad spectrum intravenous antibiotics. However tragically in this case despite showing initial signs of stabilisation, he deteriorated with refractory metabolic acidosis and disseminated intravascular coagulation, and later passed away. At postmortem, disseminated herpes simplex virus-1 (HSV-1) was found. Paediatricians are well aware of the risk factors for bacterial neonatal sepsis and actively seek information from parents to identify those children at risk. When however should a viral aetiology be considered? Should all neonates receive empirical therapy until proven otherwise? The authors review the literature surrounding neonatal HSV infection and discuss the potential pitfalls of empirical treatment.