How rare is congenital herpes simplex? A literature review.

Using three criteria--(1) herpetic infection and altered organogenesis of inflammatory etiology that antedates dissolution of the fetal membranes, (2) documented herpetic infection present at birth and within 24 hours of rupture of the fetal membranes, and (3) evidence of viral herpetic placentitis the induction of which antedates rupture of the membranes--15 cases of congenital transplacental herpes simplex were identified in the literature. Disease occurring early in gestation produces a cluster of congenital malformations that is clinically indistinguishable from that produced by the cytomegalovirus. Disease manifesting after the shortest recognized incubation period for the induction of the disease in experimental animals does not necessarily preclude transplacental acquisition. Various factors mask the perception of congenital transplacental herpes simplex as a valid disease entity.