Late recurrence of herpes simplex virus meningoencephalitis in two infants

Two infants with recurrence of herpes simplex virus (HSV) encephalitis are reported. Both patients developed HSV encephalitis during their neonatal pe riod and were treated with iv acyclovir. Long-term oral acyclovir prophylax is was given thereafter. At the age of 8 and 11 months respectively, both b abies, while under oral acyclovir prophylaxis, presented a second episode o f HSV encephalitis. An inadequate dose of suppressive oral acyclovir therap y may be responsible for the recurrence of encephalitis in these two babies . Conclusion: The present observations emphasise the need for very long fol low-up of any infant who has suffered from neonatal herpes simplex virus en cephalitis and the need for careful prospective controlled studies in order to define the appropriate treatment regimen (initial plus prophylaxis) for neonates with herpes simplex virus infections.