# Disseminated Herpes Simplex Virus-1 in Previously Healthy Child Without Skin Rash: Case report and literature review

## TL;DR

A previously healthy 1-year-old child in Saudi Arabia developed severe HSV infection without skin rash and recovered fully after treatment.

## Contribution

Reports a rare case of disseminated HSV in an immunocompetent child without skin rash.

## Key findings

- The child presented with febrile illness and altered consciousness, not typical skin rash.
- HSV was diagnosed via CSF PCR and positive IgM serology, leading to encephalitis/hepatitis.
- The child showed excellent developmental recovery after acyclovir treatment and 1-year follow-up.

## Abstract

Disseminated herpes simplex virus (HSV) is a known fatal condition in neonates and immunocompromised patients. However, very few cases have been reported in an immunocompetent host. We report a 1-year-old female child who presented to a children's hospital in Riyadh, Saudi Arabia, in 2022. She was previously healthy and presented with febrile illness associated with decrease conscious level. Upon examination, the patient had markedly elevated liver enzymes. A cerebrospinal fluid (CSF) polymerase chain reaction (PCR) finding of HSV as well as positive HSV IgM serology resulted in a diagnosis of disseminated HSV (encephalitis/hepatitis). She received acyclovir course and during follow-up for 1 year showed excellent developmental outcome.