INTRODUCTION
Ophthalmia neonatorum or neonatal conjunctivitis refers to conjunctival inflammation with associated discharge. Onset is within the first 28 days of life and transmission is by delivery via an infected birth canal. The majority of cases are bacterial, the most common bacterial agent being chlamydia; however, it is crucial to consider a viral cause.1 An often underestimated and potentially blinding cause is the herpes simplex virus (HSV), which although common in adults is rare in infants.2 Despite its rare occurrence, GPs must have a high suspicion of HSV conjunctivitis on initial presentation because misdiagnosis in a newborn with an immature immune system has sight-threatening consequences.1,2 Figures 1⇓–3 show a case example of the consequences of late diagnosis.
HERPES SIMPLEX VIRUS
HSV infections are not always apparent clinically and are common worldwide, with humans being the natural reservoirs. A key feature of HSV-1 and HSV-2 infections is their latency in neural ganglia, a lifelong burden. During its many short reproductive cycles of activation, the virus …