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.
Subject(s)
Herpes Simplex/embryology , Herpesvirus 2, Human/isolation & purification , Prenatal Diagnosis , Abortion, Eugenic , Adult , Amniotic Fluid/virology , Antibodies, Viral/analysis , Female , Herpes Simplex/diagnosis , Herpes Simplex/immunology , Herpes Simplex/virology , Herpesvirus 2, Human/classification , Herpesvirus 2, Human/immunology , Humans , Molecular Typing , Patient Education as Topic , Pregnancy , Pregnancy Trimester, Second , Young Adult , alpha-Fetoproteins/analysisABSTRACT
The expression of laminin in the vestibular ganglia and nerves in herpes simplex virus I (HSV-I) infectious chick embryos was examined by immuno-histochemistry. In 9-day-old normal chick embryos, the surface of the vestibular ganglion cells and the vestibular nerves were labelled with laminin, while, in HSV-I infectious chick embryos, the staining of laminin in the vestibular ganglia and nerves was very weak. These results suggest that HSV-I injures vestibular ganglia and nerves, and that laminin is a good marker of the degeneration and innervation of developing vestibular nerves.
