Liver failure due to disseminated HSV-1 infection in a newborn twin

Most cases of neonatal herpes simplex virus (HSV) infection result from contact with maternal genital tract secretions and are caused by infections with HSV type 2. We report on a fatal HSV-1 infection in a newborn twin presenting with liver failure, The infection was acquired by single contact with an aunt. The route of transmission was proven by PCR followed by restriction endonuclease fingerprinting and DNA sequencing, This report demonstrates that liver failure may be an early and single symptom in life-threatening neonatal HSV-1 infection.