Neonatal herpes simplex virus disease transmitted from mother to infant through breast lesions: a case report

Abstract

 A female infant weighing 2,928 grams was delivered vaginally at 39 weeks of gestation. She began direct breastfeeding from day 1 after birth. On day 16, blisters appeared on the mother’s nipples and around the areola, and papules appeared on the infant’s lips. On day 23, the papules developed into blisters, causing poor feeding and weight loss. After 2 weeks of intravenous acyclovir administration, the infant’s symptoms resolved slowly without neurological sequelae. Since the herpes simplex virus（HSV）-DNA PCR test from the infant’s lip lesion and the HSV antigen test from the mother’s breast lesion were positive, a diagnosis of neonatal HSV disease limited to the skin, eyes, and mouth due to maternal HSV transmission was made. The infant received suppressive oral acyclovir therapy for 6 months and showed normal development at the 17-month evaluation. In this case, recognition of the mother’s breast lesions led to an early diagnosis of neonatal HSV disease. Thus, it is vital for perinatal health care providers to be aware of such conditions and check for herpetic lesions on the breast, extraoral area, and genitalia.