Abstract
Among 13 neonates with HSV (8 type 2, 4 typel) infection, 8 had disseminated disease and in 4 the infection was localized to the skin and eyes. Ara-A, 10-20 mg/kg/day, was given by a continuous 12 hour intravenous drip for 10-15 days. In all, ara-A was started from 4-6 days after the first appearance of skin vesicles (s.v.) which represented the hallmark of diagnosis. Eight infants (4 disseminated and 4 localized) with s.v. as the earliest sign of infection received ara-A early within 3 days of the onset of neurologic signs (n.s.). All survived with no neurologic deficit at 6 months to 1 year of age. The other 5 infants in group I having nonspecific n.s. with delayed appearance of absence of s.v. were treated late with ara-A, (avg. 14 days after the onset of n.s.). Four died and 1 was left with severe neurologic deficits. They were initially misdiagnosed as neonatal sepsis and treated with antibiotics for 10.5 days while 4 others in the same group with good outcome received antibiotics for only 1.5 days prior to diagnosis. There was no apparent toxicity of ara-A to the bone marrow, liver or kidney. These data suggest that ara-A may be efficacious in treatment of neonatal HSV infection if given early and that early recognition of the infection even in the absence of s.v. appears essential.
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Ch'ien, L., Whitley, R., Nahmias, A. et al. HERPES SIMPLEX VIRUS (HSV) INFECTION IN NEONATES, TREATED WITH ADENINE ARABINOSIDE (ARA-A). Pediatr Res 8, 423 (1974). https://doi.org/10.1203/00006450-197404000-00496
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DOI: https://doi.org/10.1203/00006450-197404000-00496