PDF(Pubmed)
Abstract：
We present a case of a primigravida in her 30s who had a caesarean delivery of dichorionic diamniotic twins at 33 weeks of gestation. Her postpartum course was complicated by a herpes simplex virus (HSV) infection of her nipple, found after her neonates were diagnosed with HSV encephalitis. She was evaluated at her 3-week postpartum visit and reported that her neonates were concurrently admitted to the neonatal intensive care unit with disseminated neonatal HSV-1. The patient and her partner were in a monogamous relationship with no known history of HSV. Physical examination demonstrated a vertical fissure on the face of her right nipple and a small cluster of vesicles on her left hand. PCR swabs of the lesions were positive for HSV-1 at both locations. The patient was started on oral valacyclovir 1000 mg two times per day, topical acyclovir ointment applied 4-6 times per day and mupirocin ointment applied 3 times per day to her breast with resolution of her breast lesions. She was able to continue expressing her breastmilk with the help of a pump and then resumed breastfeeding once her infection was cleared. Her infants recovered after prolonged parenteral antiviral therapy with age-appropriate development at follow-up.
摘要：
我们介绍了一例30多岁的初产妇，她在妊娠33周时剖腹产双胎双胎。她的产后过程因乳头单纯疱疹病毒（HSV）感染而变得复杂，在她的新生儿被诊断为HSV脑炎后发现。在产后3周时对她进行了评估，并报告说她的新生儿同时因传播的新生儿HSV-1被送入新生儿重症监护病房。患者和她的伴侣处于一夫一妻制关系，没有已知的HSV病史。体格检查显示，她的右乳头脸上有垂直裂痕，左手上有一小群囊泡。病灶的PCR拭子在两个位置均为HSV-1阳性。患者开始口服伐昔洛韦1000mg，每天两次，局部用阿昔洛韦软膏每天应用4-6次，莫匹罗星软膏每天应用3次，以解决她的乳房病变。她能够在泵的帮助下继续表达母乳，然后在感染清除后恢复母乳喂养。她的婴儿经过长时间的肠胃外抗病毒治疗后康复，并在随访时与年龄相适应。
