Avtor/Urednik     Pirš, Mateja; Paro-Panjan, Darja; Matičič, Mojca
Naslov     Okužbe z virusom herpes simpleks pri nosečnicah in novorojenčkih
Prevedeni naslov     Herpes simplex infection during pregnancy and neonatal period
Tip     članek
Vir     Med Razgl
Vol. in št.     Letnik 45, št. Suppl 3
Leto izdaje     2006
Obseg     str. 97-108
Jezik     slo
Abstrakt     Herpes simplex infection in newborns is a rare but serious disease. Up to one third of the surviving children suffer severe neurological sequelae. The incidence of genital herpes has increased during the previous two decades. As most of the herpetic genital infections are unrecognized they represent an important risk factor for transmission of the virus to neonate. Mothers with primary genital herpes infection at the time of delivery have the highest risk of transmission to neonate, with transmission rates of over 50%. In case of non-primary first episode of genital herpes at the time of delivery the risk of transmission of the virus to neonate is 30%. In case of recurrent genital infection the risk of transmission is considerably lower, approximatelv 2%. Herpes simplex infection of the newborn is most commonly acquired during delivery; it can also be acquired in utero or postnatally. Neonatal herpetic infection can be disseminated; it can involve central nervous system infection; it can however be limited to the skin and mucous membranes. Clinical diagnosis of neonatal herpes is difficult but should be suspected in any newborn with skin lesions or acute neurological deterioration. Laboratory confirmation of herpes simplex infection can be made by detecting the presence of viral genome, antigens or the virus itself in various specimens. In neonatal herpes the treatment of choice is intravenous acyclovir in high doses. As the incidence of genital herpes has been increasing, an increase in the incidence of neonatal herpes is also expected. In order to achieve timely diagnosis, early and appropriate management, as well as cooperation, between gynecologists, pediatricians and microbiologists is essential.
Izvleček     Neonatalna okužba z virusom herpes simpleks je redka, vendar zelo resna bolezen novorojenčka, ki otroka smrtno ogroža, poleg tega pa ima do tretjina preživelih otrok nevrološke posledice. V zadnjih dveh desetletjih je prišlo do porasta pojavnosti genitalnega herpesa, večji delež okužb ostaja neprepoznan, kar predstavlja pomemben dejavnik tveganja za prenos virusa herpes simpleks na novorojenčka. Največje tveganje za prenos to okužbe na otroka je pri nosečnicah, ki prebolevajo primarno genitalno okužbo v času poroda, saj do prenosa okužbe pride v več kot 50%. V primeru neprimarne prve epizode genitalnega herpesa v času poroda je možnost za prenos okužbe 30%, v primeru ponavljajočega se zagona genitalnega herpesa v času poroda pa 2%. Do prenosa okužbe na novorojenčka lahko pride prenatalno, perinatalno ali postnatalno. Bolezen je lahko omejena na kožo in sluznice, lahko je prizadeto centralno živčevje, lahko pa se razvije generalizirana oblika bolezni. Okužba z virusom herpes simpleks nima značilnih simptomov, klinično pa na bolezen posumimo prej, če se pojavijo kožne ali nevrološke spremembe. Okužbo lahko dokazujemo z dokazom prisotnosti virusnega geno- ma, virusnih antigenov ali osamitvijo virusa iz različnih kužnin. Zdravilo izbora je aciklovir v visokih odmerkih, intravenozno. Glede na naraščanje pojavnosti genitalnega herpesa lahko pričakujemo tudi porast števila okužb novorojenčkov. Za preprečevanje in čimprejšnje odkrivanje neonatalne okužbe z virusom herpes simpleks je bistvenega pomena predvsem ustrezna in usklajena obravnava s strani ginekologov, pediatrov in mikrobiologov.
Deskriptorji     PREGNANCY COMPLICATIONS, INFECTIOUS
INFANT, NEWBORN, DISEASES
HERPES GENITALIS
INFANT, NEWBORN