Fragile preterm infant skin masking clues to a significant infection: If the pattern doesn’t fit, think HSV

An extreme preterm infant born of spontaneous preterm labour with minimal antenatal care was noted on admission to have areas of linear skin scarring and breakage. The infant was initially thought to have very fragile preterm skin. Due to these lesions being out of keeping with the purported gestational age and coupled with a petechial rash, viral infection investigations were sent and yielded a positive result for Herpes simplex
type 1.

Dr Ayanda Madide
Neonatal Registrar
ayanda.madide@nhs.net

Dr Palaniappan Sashikumar
Consultant Neonatologist

Oliver Fisher Neonatal Unit, Medway NHS Foundation Trust, Gillingham

Madide A., Sashikumar P. Fragile preterm infant skin masking clues to a significant infection: If the pattern doesn’t fit, think HSV. Infant 2025; 21(5): 139-41.

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Keywords

neonatal; congenital herpes simplex virus (HSV); preterm skin; ;

Key points

Herpes simplex virus can lead to life threatening complications.
Preterm skin can mask the appearance of HSV skin lesions.

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