Inpatient Pathway for Treatment of the Febrile Young Infant

HSV Testing POSITIVE

CONSULT INFECTIOUS DISEASES IMMEDIATELY

Blood, CSF HSV PCR POSITIVE
Lesion HSV PCR POSITIVE and
Blood CSF PCR NEGATIVE
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IV Acyclovir x 21 days
Discontinue antibacterials if cultures
negative at 24 hours
IV Acyclovir x 14 Days
Discontinue antibacterials if cultures
negative at 24 hours
Important Considerations
Disseminated Disease:

Involves multiple visceral organs, including lung, liver, adrenal glands, skin, eye, and/or the brain

Suppressive oral acyclovir:

  • Recommended following neonatal HSV disease after treatment with IV acyclovir
  • Oral acyclovir 300 mg/m2/dose three times daily for 6 months
  • Monthly CBC with differential counts to check for neutropenia are recommended while on suppressive therapy

Obtain brain MRI with gadolinium if not previously performed