Major brain lesions by intrauterine herpes simplex virus infection: MRI contribution

• Published in: Prenatal diagnosis Vol. 27; no. 1; pp. 81 - 84
• Main Authors: Duin, L. K., Willekes, C., Baldewijns, M. M. L., Robben, S. G. F., Offermans, J., Vles, J.
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01.01.2007; Wiley
• Subjects: acyclovir; Adult; Biological and medical sciences; Brain - diagnostic imaging; Brain - embryology; Brain - pathology; Brain - virology; Female; Fetal Diseases - pathology; Fetal Diseases - virology; fetus; Gynecology. Andrology. Obstetrics; Herpes Genitalis - complications; Herpes Genitalis - diagnosis; herpes simplex; Human viral diseases; Humans; hydrocephalus; infection; Infectious Disease Transmission, Vertical; Infectious diseases; magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Management. Prenatal diagnosis; Medical sciences; Pregnancy; Pregnancy Complications, Infectious - diagnosis; Pregnancy Complications, Infectious - diagnostic imaging; Pregnancy. Fetus. Placenta; Radiography; Ultrasonography; Viral diseases; Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye; Acyclic nucleoside; Purine nucleoside; Nervous system diseases; magnetic resonance imaging; hydrocephalus; Prenatal Diagnosis; Central nervous system; Herpes; Nuclear magnetic resonance imaging; In utero; Cerebral disorder; herpes simplex; Infection; Pregnancy; Viral disease; Central nervous system disease; Aciclovir; Nucleoside analog; Medical imagery; Antiviral; Fetus; acyclovir; Lesion; Hydrocephaly
• ISSN: 0197-3851; 1097-0223
• DOI: 10.1002/pd.1631

The majority of neonatal Herpes Simplex Virus (HSV) infections are acquired at birth as a consequence of direct fetal contact with the infected birth canal or through an ascending infection after premature rupture of the amniotic membranes. Intrauterine transmission of HSV infection from mother to the fetus is rare; in only 5% of the cases it occurs from haematogenous transplacental dissemination. We present a case of transplacental intrauterine HSV infection after a primary maternal HSV infection in the first trimester of pregnancy. The diagnosis was assessed by viral culture and serologic tests. Ultrasound imaging revealed fetal brain damage in the third trimester. Finally, the MRI showed the devastating extensiveness of the HSV infection, which was beyond the expectation based on the ultrasound images. Copyright © 2007 John Wiley & Sons, Ltd.