Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Perinatal/Neonatal Case Presentation
  • Published:

Perinatal/Neonatal Case Presentation

Hyperleukocytosis in a premature infant with intrauterine herpes simplex encephalitis

Abstract

Herpes encephalitis is a rare but devastating infection in premature infants. We report a 29 week gestation infant with severe intrauterine cutaneous and central nervous system herpes accompanied by hyperleukocytosis. Leukemoid reactions are not uncommon in this population, but the association of herpes encephalitis and a leukemoid reaction or hyperleukocytosis has not been reported previously.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Kimberlin DW . Management of HSV encephalitis in adults and neonates: diagnosis, prognosis and treatment. Herpes 2007; 14 (1): 11–16.

    PubMed  Google Scholar 

  2. O′Riordan DP, Golden WC, Aucott SW . Herpes simplex virus infections in preterm infants. Pediatrics 2006; 118 (6): e1612–e1620.

    Article  Google Scholar 

  3. Whitley RJ, Nahmias AJ, Visintine AM, Fleming CL, Alford CA . The natural history of herpes simplex virus infection of mother and newborn. Pediatrics 1980; 66 (4): 489–494.

    CAS  PubMed  Google Scholar 

  4. Hutto C, Arvin A, Jacobs R, Steele R, Stagno S, Lyrene R et al. Intrauterine herpes simplex virus infections. J Pediatr 1987; 110 (1): 97–101.

    Article  CAS  Google Scholar 

  5. Baldwin S, Whitley RJ . Intrauterine herpes simplex virus infection. Teratology 1989; 39 (1): 1–10.

    Article  CAS  Google Scholar 

  6. Rastogi S, Rastogi D, Sundaram R, Kulpa J, Parekh AJ . Leukemoid reaction in extremely low-birth-weight infants. Am J Perinatol 1999; 16 (2): 93–97.

    Article  CAS  Google Scholar 

  7. Krumbhaar E . Leukemoid blood pictures in various clinical conditions. Am J Med Sci 1926; 172: 519–533.

    Article  Google Scholar 

  8. Calhoun DA, Kirk JF, Christensen RD . Incidence, significance, and kinetic mechanism responsible for leukemoid reactions in patients in the neonatal intensive care unit: a prospective evaluation. J Pediatr 1996; 129 (3): 403–409.

    Article  CAS  Google Scholar 

  9. Steel JH, Malatos S, Kennea N, Edwards AD, Miles L, Duggan P et al. Bacteria and inflammatory cells in fetal membranes do not always cause preterm labor. Pediatr Res 2005; 57 (3): 404–411.

    Article  Google Scholar 

  10. Zhou X, Brotman RM, Gajer P, Abdo Z, Schuette U, Ma S et al. Recent advances in understanding the microbiology of the female reproductive tract and the causes of premature birth. Infect Dis Obstet Gynecol 2010; 2010: 737425.

    Article  Google Scholar 

  11. Chatterjee A, Chartrand SA, Harrison CJ, Felty-Duckworth A, Bewtra C . Severe intrauterine herpes simplex disease with placentitis in a newborn of a mother with recurrent genital infection at delivery. J Perinatol 2001; 21 (8): 559–564.

    Article  CAS  Google Scholar 

  12. Barak M, Cohen A, Herschkowitz S . Total leukocyte and neutrophil count changes associated with antenatal betamethasone administration in premature infants. Acta Paediatr 1992; 81 (10): 760–763.

    Article  CAS  Google Scholar 

  13. Haase R, Merkel N, Diwan O, Elsner K, Kramm CM . Leukapheresis and exchange transfusion in children with acute leukemia and hyperleukocytosis. A single center experience. Klinische Padiatrie 2009; 221 (6): 374–378.

    Article  CAS  Google Scholar 

  14. Romano MJ, Weber MD, Weisse ME, Siu BL . Pertussis pneumonia, hypoxemia, hyperleukocytosis, and pulmonary hypertension: improvement in oxygenation after a double volume exchange transfusion. Pediatrics 2004; 114 (2): e264–e266.

    Article  Google Scholar 

  15. Donoso AF, Cruces PI, Camacho JF, Leon JA, Kong JA . Exchange transfusion to reverse severe pertussis-induced cardiogenic shock. Pediatr Infect Dis J 2006; 25 (9): 846–848.

    Article  Google Scholar 

  16. Duran R, Ozbek UV, Ciftdemir NA, Acunas B, Sut N . The relationship between leukemoid reaction and perinatal morbidity, mortality, and chorioamnionitis in low birth weight infants. Int J Infect Dis 2010; 14 (11): e998–1001.

    Article  Google Scholar 

  17. Mahon BE, Yamada EG, Newman TB . Problems with serum IgM as a screening test for congenital infection. Clin Pediatr 1994; 33 (3): 142–146.

    Article  CAS  Google Scholar 

  18. Sullender WM, Miller JL, Yasukawa LL, Bradley JS, Black SB, Yeager AS et al. Humoral and cell-mediated immunity in neonates with herpes simplex virus infection. J Infect Dis 1987; 155 (1): 28–37.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We thank John W Bishop MD, Director of Anatomic Pathology, UC Davis Medical Center, for review of the placental pathology and special staining. This work was financially supported by MU: NIH HD059127 (NICHD). This publication was also made possible by Grant number UL1 RR024146 from the National Center for Research Resources (NCRR), a component of the NIH.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M A Underwood.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Supplementary Information accompanies the paper on the Journal of Perinatology website

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Cite this article

Underwood, M., Wartell, A. & Borghese, R. Hyperleukocytosis in a premature infant with intrauterine herpes simplex encephalitis. J Perinatol 32, 469–472 (2012). https://doi.org/10.1038/jp.2011.138

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2011.138

Keywords

This article is cited by

Search

Quick links