What are complications of herpes simplex virus (HSV) infection?

Updated: Mar 17, 2020
  • Author: Sean P McGregor, DO, PharmD; Chief Editor: William D James, MD  more...
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The most common complication of herpes simplex virus (HSV) infections is bacterial superinfection. In women with primary HSV-2 infection, aseptic meningitis is also common.

Significant complications, such as visceral and CNS dissemination and long-term sequelae, are rare and occur in patients who are immunocompromised or in cases of neonatal HSV.

Patients with AIDS who are treated with intravenous acyclovir may develop thymidine kinase–negative strains of HSV that are resistant to acyclovir. These patients may be successfully treated with intravenous foscarnet or cidofovir.

Babies born to mothers with genital HSV infection should be closely monitored for any signs of infection and promptly treated if signs of the disease develop. Preterm babies are at higher risk and HSV infection should be considered in preterm babies with a maternal history of HSV infection, prolonged rupture of membranes, and leukopenia. [43] Neonatal HSV infection has a mortality rate of more than 80% if untreated and a mortality/significant morbidity rate of approximately 50% even when treated.

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