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Full text and additional images for Herpes Simplex Virus Blepharitis are available in VisualDx. VisualDx is a web-based clinical decision support system used in over 1,500 hospitals and large clinics. Full text and additional images for Neonatal Herpes Simplex Virus are available in VisualDx. Neonates delivered from mothers who have had their first episode of HSV during gestation (primary HSV) are at greatest risk for neonatal HSV. There is increased lacrimation in severe cases.The spectrum of ocular herpetic disease also includes conjunctivitis, iritis, and keratitis.

Epithelial keratitis involves only the superficial layer of the cornea and although less severe still can lead to scarring and vision loss. These neonates are frequently premature and can have associated microcephaly, chorioretinitis, and cerebral abnormalities. Stromal keratitis, however, involves deeper layers of the cornea and also may lead to vision loss.Primary ocular HSV infections occur most often in children between the ages of 6 months and 5 years, and such infections almost always present as blepharitis or blepharoconjunctivitis. Disseminated disease can involve the liver, lungs, or present as disseminated intravascular coagulation.Maternal history of HSV infection could help aid the diagnosis, but most women are asymptomatic and it is, therefore, not a reliable clue.
Corneal involvement with HSV necessitates treatment with antiviral agents to prevent complications.Differentiate this condition from preseptal or orbital cellulitis on the basis of vesicles and ulcerations.

Intrauterine infection presents typically with scarring skin lesions, ophthalmologic findings, and neurologic involvement. Disseminated HSV infection in the neonate can cause encephalitis and is potentially a life-threatening condition. Rapid antiviral therapy is imperative in neonates with suspected HSV infection.For a discussion of HSV acquired by older infants, see herpes simplex virus.

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