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Febrile Infant: HSV Risk

HSV risk factors:

  • Ill appearance (off guideline)
  • Prematurity: <37 weeks EGA - off guideline
  • Maternal history of genital HSV lesions 
  • Maternal fever from 48 hours before to 48 hours after delivery
  • Vesicles or mucous membrane ulcers
  • Seizure
  • Hypothermia: <36°C
  • CSF pleocytosis without positive Gram stain: WBC >15/mm3
  • Leukopenia: <5,000/mm3
  • Thrombocytopenia: <150/mm3
  • Elevated alanine aminotransferase (if obtained)
  • HSV highest in the first four weeks

Diseases, A.C.o.I., Kimberlin, D.W., Brady, M.T., & Jackson, M.A. (2018, May 1). Red Book : 2018 Report of the Committee on Infectious Diseases - 31st ed (31 ed.). https://doi.org/10.1542/9781610021470

These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.

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