HealthDay News — Young infants assessed for central nervous system (CNS) infection rarely have herpes simplex virus (HSV), according to a study published in Pediatrics.

Andrea T. Cruz, MD, MPH, from the Baylor College of Medicine in Houston, and colleagues conducted a retrospective cross-sectional study of infants aged 60 days or younger who had cerebrospinal fluid culture testing performed in 23 participating emergency departments. The authors examined the proportion of encounters in which HSV infection was identified.

The researchers found that HSV was identified in 0.42% of the 26,533 eligible encounters. Overall, 80.4%, 8.9%, and 10.7% of these occurred in weeks 1 to 4, 5 to 6, and 7 to 9, respectively. HSV-infected infants had a median age of 14 days. 

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HSV infection was more common among infants aged 0 to 28 days vs those aged 29 to 60 days (odds ratio, 3.9). A total of 0.26% of infants had CNS or disseminated HSV. Across sites, there was wide variation in the proportion of infants tested for HSV (35%; range, 14% to 72%) and to whom acyclovir was administered (23%; range, 4% to 53%).

“HSV infection was uncommon in young infants evaluated for CNS infection, particularly in the second month of life,” the authors write. “Evidence-based approaches to the evaluation for HSV in young infants are needed.”

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Cruz AT, Freedman SB, Kulik DM, et al. Herpes simplex virus infection in infants undergoing meningitis evaluation [published online January 3, 2018]. Pediatrics. doi: 10.1542/peds.2017-1688