EARLY DIAGNOSIS OF NEONATAL HERPES SIMPLEX VIRUS INFECTION BY GUTHRIE CARDS EXAMINATION

Neonatal herpes simplex virus (HSV) infection acquired at deliver), is characterised by high morbidity and mortality. Prompt therapy with acyclovir improves the prognosis in terms of both mortality and psychomotor development. Based on our experience acquired in the use of Guthrie cards to diagnose congenital cytomegalovirus infection (Barbi et al. 1996) and on the observation that HSV spread occurs by the haematic route in neonates we thought it interesting to test retrospectively the Guthrie cards of three babies in which a disseminated HSV infection in the first two weeks oflife had been suspected. Two of the babies were dead before a vira) diagnosis was available, the third had started the acyclovir treatment 14 days alter the onset of the disease. HSV-1 and HSV-2 DNA were sought in the blood eluted from the cards by nested PCR. HSV-2 but not HSV- I DNA was amplified from the cards which had been collected from two babies before the e day of life and in her 1621 day, at the beginning of the disease, from the third. Although these results concem only three cases and need confirmation from our ongoing study, they could be important. Testing Guthrie cards for HSV DNA represents a non invasive, rapid and widely available method that could be centralised in specialised structures. Its application would allow the prompt institution of antiviral treatment in neonates with suspected HSV infection thus contributing to the success of the treatment.