Pediatric Hospital Medicine 2012

Diagnosis and Management of Neonatal HSV: Why is There Such Variability in Practice?
Aaron Miller, Jeffrey Bennett
At the conclusion of this session, participants will be able to:

  1. Recognize which febrile or sick infants should be tested for HSV
  2. Identify what diagnostic tests should be ordered
  3. Identify when should infants be started on empiric acyclovir
  4. Identify when empiric acyclovir should be discontinued

The recognition, diagnosis and management of neonatal HSV infection are important skills of a pediatric hospitalist. Neonates with fever present a unique challenge in regard to HSV because there are not clear recommendations about which infants require HSV testing, what type of testing to perform and when to start and discontinue empiric acyclovir. This lack of clear recommendations has resulted in a wide range of approaches to neonatal HSV, both within and between institutions. The goal of this session is to discuss this variability in practice, review the data on neonatal HSV and propose a guideline/algorithm for the initial evaluation of HSV in the febrile or sick neonate. This session will incorporate recently published literature on neonatal HSV disease and address challenging clinical issues such as which diagnostic tests should be performed and when to discontinue empiric acyclovir.




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