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Individual neurological complication caused by Herpes simplex viruses in neonates is well-known. We report neonatal Herpes encephalitis that caused multiple neurological complications in the same patient during acute phase of illness. Our patient differs from previously reported cases in the following ways: 1) Late onset neonatal presentation; 2) Development of multiple neurologic complications during acyclovir therapy; 3) Cesarean-section did not prevent perinatal transmission of Herpes simplex virus; and 4) Our patient’s acute hydrocephalus was managed conservatively and he had no reoccurrence of seizure, hydrocephalus, and no motor deficits. A high degree of suspicion, timely needed supportive medical and surgical care, and prompt initiation of intravenous acyclovir offer the best chance for neurological outcome in neonates with Herpes encephalitis.

Late Onset Neonatal Herpes Encephalitis: A Case-Based CNS Complication and Neurological Outcome