pediatrics
Neonatal Herpes Simplex Virus (HSV) Infection
Diagnosis of Neonatal HSV Infection
HSV culture or polymerase chain reaction (PCR) testing Sometimes immunofluorescent testing of lesions or electron microscopy Rapid diagnosis by viral culture or HSV PCR is essential. The most common site of retrieval is skin vesicles. The nasopharynx, eyes, rectum, blood, and cerebrospinal fluid should also be tested. In some neonates with encephalitis, virus is present only in the CNS. Diagnosis of neonatal HSV also can be made by immunofluorescence of lesion scrapings, particularly with use of monoclonal antibodies, and electron microscopy. If no diagnostic virology facilities are available, a Tzanck test of the lesion base may show characteristic multinucleated giant cells and intranuclear inclusions, but this test is less sensitive than culture, and false-positives can occur. 