TY - JOUR T1 - Herpes simplex ophthalmia neonatorum: a sight-threatening diagnosis JF - British Journal of General Practice JO - Br J Gen Pract SP - 513 LP - 514 DO - 10.3399/bjgp20X712973 VL - 70 IS - 699 AU - Nimra Maqsood AU - Usman Mahmood Y1 - 2020/10/01 UR - http://bjgp.org/content/70/699/513.abstract N2 - 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.Figure 1. Mother experienced herpetic genital lesions 2 days after vaginal delivery. Onset of neonate’s symptoms on day 5, treated as bacterial infection. Late diagnosis of HSV-1 at week 3 (fluorescein staining).Figure 2. One week after admission.Figure 3. Follow-up 10 months after initial review. Final diagnosis: right-eye herpetic disease (permanent scarring) with secondary glaucoma eventually requiring tube shunt surgery.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 … ER -