An infant delivered at 29 weeks' gestation with a birth weight of 1.06 kg was noted to have large, coalescent patches of hypopigmentation that were most prominent on the back (Figure 1). Routine cranial ultrasonography revealed extensive multicystic encephalomalacia (Figure 2). Bilateral chorioretinal scarring and optic atrophy were present on ophthalmologic examination (Figure 3). Results of an electroencephalogram and testing of acoustic and visual evoked reflexes were markedly abnormal.
Denouement and Discussion
Intrauterine Herpes Simplex Virus Infection
The estimated incidence of neonatal herpes simplex virus (HSV) infection varies from 1 in 2000 to 1 in 5000 live births in the United States per year.1 Neonatal HSV disease may involve either the type 1 or 2 virus, with the latter accounting for approximately 75% of the isolates from infected neonates.2 The HSV may be transmitted to the fetus or newborn in utero, at the intrapartum stage, or postnatally. Although