Congenital HSV-2 infection with atypical skin lesions, chorioretinitis, and neurodevelopmental sequelae: a case report

This case highlights that congenital HSV-2 infection can present with atypical cutaneous findings at delivery, mandating high clinical suspicion and immediate empirical antiviral therapy. An initially negative CSF HSV PCR and benign cytochemistry do not guarantee against subsequent ocular or neurological involvement. This report emphasizes the imperative for routine ophthalmologic screening, extended intravenous therapy when dissemination cannot be ruled out, consideration of oral suppression in high-risk infants, and long-term, multidisciplinary follow-up for all neonates diagnosed with HSV infection, irrespective of the initial disease classification.