What is neonatal herpes?

- [Voiceover] A pregnant woman that's infected with herpes and who delivers a baby with open sores can give their baby Neonatal Herpes, Neonatal Herpes. And I've got a picture of a baby here, and we're going to go through the three different types of Neonatal Herpes a newborn baby can have. The first type of Neonatal Herpes that a baby can have is referred to as SEM Herpes, SEM Herpes. And the name actually helps us remember what gets affected. The S refers to the fact that the baby's skin can have these herpes lesions or sores, and these mainly occur wherever the baby has skin tears, so skin tears. So for example, if the baby was delivered with forceps, there may be tears on the baby's scalp where the forcep was applied. And these places can get in contact with the herpes lesions that a mother may have, and they can cause the baby to have sores there like I've drawn here. Other than the skin, the baby can also have herpes in the eyes, and we've already talked a little bit about this. Herpes in the eyes affects the most central part of the eye called the cornea, and so you'll see sort of a lattice-like or a, what's termed, dendritic lesion on the center or the cornea of the eye. And if it's left untreated, this can actually lead to blindness. So that's the E in SEM Herpes. The M refers to the mouth, and these will be your classic coldsores, so your coldsores that can occur on the lips, on the inside of your cheeks or even on the tip of the tongue. Now what I've hope you've noticed through these three different systems that get affected is that none of them involve the internal organs, so there's no internal organ involvement, which makes this the least severe type of the three we're going to discuss. The next severe level of Neonatal Herpes a baby can have is what's referred to as Disseminated Herpes, which as the name suggests is disseminated more throughout the body, which now means that internal organs are involved. And the organ that's most commonly infected or affected is the liver, so I'm drawing the liver over here, and I am purposely drawing it to be huge because the baby will have the herpes virus spread here and white blood cells, so I'll make sure to write that this symbol refers to the herpes virus. So the herpes virus will spread here, and white blood cells will fight the herpes virus here in the liver, causing the liver to swell with the incoming white blood cells and the fluid that results from it. So when your liver is affected, the term for this is hepato, hepato referring to the liver, megaly, hepatomegaly, which just means large liver. And of the three types of herpes we're going to talk about here, this type of Neonatal Herpes has the highest mortality or has the highest rate of death associated with it. And finally, the last type of Neonatal Herpes is what's referred to as CNS Herpes or herpes of the central nervous system, and that means that the herpes can spread to either the spine or the brain, and you have a different set of symptoms, depending on what part of the CNS is affected. For the spine up here, what you'll most commonly see are tremors. There are these tremors that the baby will have. If you take a look at their hands or their feet, there's going to be a very steady shake to them, which makes sense because the spinal cord gives off nerves that control the rest of your body beyond the brain. Now in the brain though, once we have this type of dynamic, where white blood cells are fighting the herpes virus up there, you can start to make the baby tired. And so, they could be in a state of lethargy, so I'll draw some Zs right there because the baby's going to sleep. And this is actually kind of a bad finding because what it indicates is that the nerves that are in the brain that are supposed to send messages to the rest of the body or to keep the baby awake are being destroyed because of the white blood cells fighting the virus there. Another thing you might see is that the baby could have seizures that result from this type of inflammation, so the white blood cells fighting the herpes virus and causing inflammation, so I'll write that term here 'cause that's an important term to keep in mind, so there's inflammation that's happening within the brain. And as a result of inflammation, you're going to have increased pressure in the brain. And the term for that is increased intracranial, the cranium being the skull, so intracranial pressure, so increased intracranial pressure, which actually has its own symptom associated with it. You could get a bulging fontanelle or multiple fontanelles, bulging fontanelles, and fontanelles are just the soft spots of a baby's skull that are still healing. Classically, there's the anterior fontanelle that sits at the top or the vertex of the skull, and it's usually very soft, and it's within the shape of the skull. But sometimes, if you're having increased intracranial pressure, it will bulge, and you'll see it actually as a protuberance at the top of the skull right here. And that's an indication that you have inflammation causing increased intracranial pressure in the baby. And because the brain is responsible for so much, one of the things that makes sense that occurs because of CNS Herpes is that this type of Neonatal Herpes is associated with the highest morbidity or the highest rate of long-term complications that can include mental retardation, cerebral palsy, or other types of neuronal slowing that exists throughout life, which makes it very important to catch a pregnant woman that is infected with herpes early on.