A neonate develops disseminated herpes with hepatitis and encephalitis at day 5 of life. His mother had no visible genital lesions. The preferred treatment is:
- A Aciclovir 60 mg/kg/day IV in three divided doses for 21 days ✓
- B Ganciclovir 12 mg/kg/day IV for 6 weeks
- C Valaciclovir 500 mg orally twice daily
- D Foscarnet 90 mg/kg IV every 12 hours
Correct answer: A. Aciclovir 60 mg/kg/day IV in three divided doses for 21 days
Explanation
Neonatal HSV disseminated disease and CNS HSV infection are treated with high-dose IV aciclovir 60 mg/kg/day divided every 8 hours for 21 days (CNS/disseminated) or 14 days (skin/eye/mouth disease). This regimen significantly reduces mortality and neurological sequelae. Ganciclovir is used for congenital CMV. Valaciclovir oral bioavailability is insufficient for severe neonatal HSV. Foscarnet is reserved for aciclovir-resistant HSV, typically in immunocompromised patients.
Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.