Severe Ocular Neonatal Herpes Simplex Virus Type 2 Infecton : A Case Report

Abstract

We reported a case of a 42 days old baby girl who was diagnosed with bilateral acute retinal necrosis with tractional retinal detachment. She was earlier diagnosed to have disseminated Herpes Simplex Virus (HSV) type 2 infection with encephalitis and treated by the paediatrics team with intravenous aciclovir. She was referred for routine eye assessment and dilated fundus examination revealed extensive peripheral retinal necrosis with some areas of resolving retinitis involving the right macula but sparing the left macula. The ocular disease progressed and tractional retinal detachment developed bilaterally needing vitreoretinal intervention. However, her systemic diseases worsened and she passed away at another tertiary hospital while waiting for the vitreoretinal surgery. This case demonstrates that a patient with such severe retinal necrosis might have normal anterior segment findings. Therefore, it is recommended that all neonates with systemic herpetic infection should be referred ophthalmological assessment early even in the absence of external eye signs as early antiviral treatment can minimise complications of acute retinal necrosis.