acyclovir and Endometritis

Herpes simplex virus (HSV) is an unusual cause of postpartum endometritis. We describe a rare case of primary disseminated maternal HSV in the postpartum period associated with endometritis.. A previously healthy patient developed fundal tenderness and postpartum fevers after an uncomplicated vaginal delivery. Despite traditional broad-spectrum antimicrobial therapy, she had persistent fevers and systemic symptoms. Concurrently, her neonate developed fevers and a nonvesicular rash, with viral cultures ultimately returning positive for HSV. The patient developed active pharyngeal and genital herpetic lesions and was diagnosed with HSV endometritis and disseminated HSV. Symptoms and fevers in both the mother and neonate responded to antiviral therapy.. Herpes simplex virus endometritis should be included in the differential diagnosis for postpartum fevers and fundal tenderness that are unresponsive to broad-spectrum antimicrobial treatment.

Topics: Acyclovir; Adult; Antiviral Agents; Endometritis; Exanthema; Female; Fever; Herpes Simplex; Herpesvirus 2, Human; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical; Male; Postpartum Period; Pregnancy; Pregnancy Complications, Infectious; Tomography, X-Ray Computed

Herpes simplex virus (HSV) can cause postpartum endometritis. The clinical diagnosis of HSV endometritis has been reported previously. The disease is responsive to acyclovir intravenously.. A 22-year-old woman, gravida 2, para 1, status post primary cesarean section for a double footling breech presentation, developed a persistent postpartum fever. Simulating the febrile course of septic pelvic thrombophlebitis, the patient's condition was unresponsive to broad-spectrum antimicrobials and heparin therapy. Active herpetic lesions and a positive cervical culture for herpes simplex prompted the use of intravenous acyclovir. Rapid resolution of the fever and the similarity to previous case reports suggested the clinical diagnosis of herpes simplex endometritis.. The diagnosis of postpartum herpes simplex endometritis should be considered when managing a persistent postpartum fever unresponsive to aggressive antimicrobial and heparin therapy. Immediate resolution of the fever should occur with the use of acyclovir.

Topics: Acyclovir; Adult; Antiviral Agents; Breech Presentation; Cesarean Section; Diagnosis, Differential; Endometritis; Female; Fever; Herpes Simplex; Humans; Infusions, Intravenous; Postoperative Complications; Postpartum Period; Pregnancy