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Vol. 33, No. 2, 2013
Issue release date: March 2013

Midtrimester Fetal Herpes Simplex-2 Diagnosis by Serology, Culture and Quantitative Polymerase Chain Reaction

Curtin W.M. · Menegus M.A. · Patru M.-M. · Peterson C.J. · Metlay L.A. · Mooney R.A. · Stanwood N.L. · Scheible A.L. · Dorgan A.
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Abstract

The acquisition of herpes simplex virus (HSV) in utero comprises a minority of neonatal herpes infections. Prenatal diagnosis is rare. We describe a midtrimester diagnosis of fetal HSV-2 infection. Ultrasound at 20 weeks for elevated maternal serum α-fetoprotein (MSAFP) showed lagging fetal growth, echogenic bowel, echogenic myocardium, and liver with a mottled pattern of echogenicity. Amniocentesis demonstrated normal karyotype, elevated AFP and positive acetylcholinesterase. Culture isolated HSV-2 with an aberrant growth pattern. Maternal serology was positive for HSV-2. Quantitative DNA polymerase chain reaction (PCR) showed 59 million copies/ml. Fetal autopsy demonstrated widespread tissue necrosis but only sparse HSV-2 inclusions. Fetal HSV-2 infection can be suspected when an elevated MSAFP accompanies ultrasound findings suggesting perinatal infection. Maternal HSV serology, amniotic fluid culture and quantitative PCR are recommended for diagnostic certainty and counseling.



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References

  1. Corey L, Wald A: Maternal and neonatal HSV infections. N Engl J Med 2009;361:1376-1385.
  2. Brown ZA, Selke SA, Zeh J, Kopelman J, Maslow A, Ashley RL, Watts DH, Berry S, Herd M, Corey L: Acquisition of herpes simplex virus during pregnancy. N Engl J Med 1997;337:509-515.
  3. Morrow R, Friedrich D: Performance of a novel test for IgM and IgG antibodies in -subjects with culture-documented genital herpes simplex virus-1 or -2 infection. Clin Microbiol Infect 2006;12:463-469.
  4. Gupta R, Warren T, Wald A: Genital herpes. Lancet 2007;370:2127-2137.
  5. Lanouette JM, Duquette DA, Jacques SM, Qureshi F, Johnson MP, Berry SM: Prenatal diagnosis of fetal herpes simplex infection. Fetal Diagn Ther 1996;11:414-416.
  6. Mitra AG, O'Malley DP, Banks PM, Kelly M: Myocardial calcification in a fetus: a distinctive presentation of in utero herpes simplex virus type II infection. J Ultrasound Med 2004;23:1385-1390.

    External Resources

  7. Diguet A, Patrier S, Eurin D, Chouchene S, Marpeau L, Laquerrière A, et al: Prenatal diagnosis of an exceptional intrauterine herpes simplex infection. Prenat Diagn 2006;26:154-155.
  8. Kimberlin DW: Herpes simplex virus infections of the newborn. Semin Perinatol 2007;31:19-25.
  9. Alanen A, Hukkanen V: Herpes simplex virus DNA in amniotic fluid without neonatal infection. Clin Infect Dis 2000;30:363-367.
  10. Tang JW, Lin M, Chiu L, Koay ES: Viral loads of herpes simplex virus in clinical samples - a 5-year retrospective analysis. J Med Virol 2010;82:1911-1916.
  11. Ville Y: CMV review. Fetal Diagn Ther 2012, in press.


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