Neonatology: neonatal herpes simplex infection: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Neonatology: neonatal herpes simplex infection

Sample item

A 10-day-old term baby has a cluster of vesicles on the scalp, then develops lethargy, poor feeding and a seizure. The mother had a genital lesion at delivery. Which treatment should be started immediately?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Intravenous acyclovir

Neonatal herpes simplex infection presents as skin-eye-mouth disease, CNS disease or disseminated infection, and treatment is high-dose intravenous acyclovir given promptly without waiting for confirmation. CSF and vesicle fluid PCR confirm the diagnosis. Delay worsens neurological outcome and mortality.

Option by option

  • A. Intravenous ceftriaxone

    Ceftriaxone does not treat a viral infection and is also avoided in neonates with jaundice.

  • B. Oral valaciclovir

    Oral valaciclovir is not adequate for a sick neonate with possible CNS disease.

  • C. Intravenous ganciclovir

    Ganciclovir is used for cytomegalovirus, not herpes simplex.

  • D. Intravenous acyclovir (correct)

    Correct. Intravenous acyclovir is the treatment of choice for neonatal HSV.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is D, Intravenous acyclovir. Neonatal herpes simplex infection presents as skin-eye-mouth disease, CNS disease or disseminated infection, and treatment is high-dose intravenous acyclovir given promptly without waiting for confirmation.

Why is "Intravenous ceftriaxone" not the answer?

Ceftriaxone does not treat a viral infection and is also avoided in neonates with jaundice.

Why is "Oral valaciclovir" not the answer?

Oral valaciclovir is not adequate for a sick neonate with possible CNS disease.

Why is "Intravenous ganciclovir" not the answer?

Ganciclovir is used for cytomegalovirus, not herpes simplex.

What concept does this question test?

It tests Neonatology: neonatal herpes simplex infection in Pediatrics. CSF and vesicle fluid PCR confirm the diagnosis. Delay worsens neurological outcome and mortality.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neonatology: neonatal herpes simplex infection?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.