Eczema Herpeticum in Pregnancy and Neonatal Herpes Infection

Abstract

Eczema herpeticum is caused by herpes simplex infection of atopic dermatitis. The infection typically causes a vesiculopustular rash, but can disseminate and be life threatening. A primigravida with a history of eczema and hypogammaglobulinemia presented at 28 weeks of gestation with preterm labor, fever, and extensive rash. After failed tocolysis, she delivered vaginally. Prompt treatment with parenteral acyclovir was initiated for both patients based on a clinical diagnosis of maternal eczema herpeticum. Cultures confirmed the diagnosis of eczema herpeticum and rectal swab of the infant was positive for herpes simplex virus. The mother and infant did well. Early diagnosis and treatment of eczema herpeticum is necessary to prevent poor outcomes in pregnancy. Prophylactic acyclovir may help prevent eczema herpeticum in pregnancy.