Factors Associated With HSV PCR CSF Testing and Empiric Acyclovir Therapy in Young Febrile Infants. Clin Pediatr (Phila) 2019 Oct;58(11-12):1194-1200
Date
08/15/2019Pubmed ID
31409122DOI
10.1177/0009922819868687Scopus ID
2-s2.0-85071503792 (requires institutional sign-in at Scopus site) 1 CitationAbstract
Herpes simplex virus (HSV) infection in infants is a devastating disease with an often subtle presentation. We examined cerebrospinal fluid (CSF) HSV PCR (polymerase chain reaction) testing and empiric acyclovir therapy in young febrile infants. Chart review identified hospitalized infants aged ≤60 days with fever ≥38°C who had undergone lumbar puncture. Previously published criteria were used to define patients at high risk for HSV. Primary outcomes were CSF HSV PCR testing and empiric acyclovir therapy. Of 536 febrile infants, 23% had HSV testing; empiric acyclovir was started in 15%. HSV testing and therapy were associated with younger age, seizure, maternal vaginal lesions, postnatal HSV contact, vesicles, poor tone, CSF pleocytosis, and enteroviral testing. Sixty-two percent of high-risk infants did not undergo HSV testing, and 75% did not receive acyclovir. High-risk infants were untested and untreated at relatively high rates. Evidence-based criteria to guide HSV testing and treatment are needed.
Author List
Swartz S, Hadjiev J, Kolinski J, Chou E, Allen K, Yan K, Havens PLAuthors
Erica Y. Chou MD Director, Assistant Professor in the Pediatrics department at Medical College of WisconsinJennifer M. Hadjiev MD Chief, Associate Professor in the Pediatrics department at Medical College of Wisconsin
Julie M. Kolinski MD Associate Professor in the Medicine department at Medical College of Wisconsin
Sheila Swartz MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Ke Yan PhD Associate Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AcyclovirAntiviral Agents
Female
Fever
Herpes Simplex
Humans
Infant
Infant, Newborn
Male
Polymerase Chain Reaction
Spinal Puncture
Treatment Outcome
