Case 2: Vesicular Lesions of the Oral Mucosa

Abstract

A term female infant (39+4 weeks) with a birthweight of 3,055 g is born via spontaneous delivery to a gravida 4, para 3 woman. Maternal history is significant for Ashkenazi Jewish heritage and known connective tissue disease requiring plaquenil. Maternal serologies and prenatal testing are unremarkable with the exception of herpes simplex virus (HSV) 1 immunoglobulin (Ig) G being positive and IgM inconclusive. The mother was not taking antiviral therapy during pregnancy or at delivery. On admission to the labor and delivery department, the infant’s mother is without prodromal symptoms or genital lesions concerning for HSV. The patient is born via spontaneous vaginal delivery through meconium-stained amniotic fluids, with Apgar scores of 8 and 9 at 1 and 5 minutes, respectively. At the time of delivery, the infant has normal physical examination findings and is kept in the mother-baby unit for routine newborn care. At about 30 hours after birth, the newborn team is called to the bedside by the nurses because of the development of vesicular lesions on the oral mucosa of the lower lip (Fig). On examination of the oral mucosa, multiple vesicular lesions are noted, which measure 1 to 2 mm in size. Because of …