{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T09:21:22Z","timestamp":1783070482467,"version":"3.54.6"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2014,6,9]],"date-time":"2014-06-09T00:00:00Z","timestamp":1402272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Neonates with blistering skin diseases are dermatologic emergencies. The pathologies involved can pose diagnostic difficulties and there exists a variety of potential life\u2010threatening differential diagnoses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>description of the first case of intrauterine acquired herpes simplex virus (HSV) 1 infection in twins.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We present the case of two premature bicordial biamniotic twins (27th week of gestation) whose intrauterine growth retardation, fetal anaemia and cardiotocography abnormalities led to a caesarean emergency delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Accurate medical history revealed a maternal febrile gingivostomatitis at the 23rd week of gestation, which was neglected by the treating gynaecologist. Respiratory distress was present at delivery and intubation was necessary in both children. The whole skin showed extensive erosions and ulcerations and the mucosa of the eyes and genitals was also involved. Intrauterine Herpes simplex virus (<jats:styled-content style=\"fixed-case\">HSV<\/jats:styled-content>) 1 infection was confirmed by immunohistochemistry of skin Tzanck smear (<jats:styled-content style=\"fixed-case\">HSV<\/jats:styled-content> 1 positive, <jats:styled-content style=\"fixed-case\">HSV<\/jats:styled-content> 2 negative), real\u2010time polymerase chain reaction of both serum and skin (<jats:styled-content style=\"fixed-case\">HSV<\/jats:styled-content> 1 positive; <jats:styled-content style=\"fixed-case\">HSV<\/jats:styled-content> 2 negative) and maternal serology positive for <jats:styled-content style=\"fixed-case\">HSV<\/jats:styled-content> 1 IgM and IgG. Siblings were immediately treated with high\u2010dose endovenous acyclovir. Anaemia thrombocytopenia and hepatorenal values markedly deteriorated and both developed consequential hepatorenal failure. The third day live supportive measures were terminated after parental informed consent and both siblings deceased shortly after on their mother's breast.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Intrauterine <jats:styled-content style=\"fixed-case\">HSV<\/jats:styled-content> infection is rare and accounts only for 5% of neonatal <jats:styled-content style=\"fixed-case\">HSV<\/jats:styled-content> infections. Literature reports only 64 cases and 90% of those are related to <jats:styled-content style=\"fixed-case\">HSV<\/jats:styled-content>\u20102. Transplacental viral transmission is highest during the first 20\u00a0weeks of gestation and has been observed in pregnant women with disseminated <jats:styled-content style=\"fixed-case\">HSV<\/jats:styled-content> infection. Mortality and morbidity of intrauterine herpetic infection are extremely high.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite transplacental <jats:styled-content style=\"fixed-case\">HSV<\/jats:styled-content> transmission remains a rare event, the potential devastating outcome justifies immediate adequate antiviral treatment in a pregnant woman affected by primary <jats:styled-content style=\"fixed-case\">HSV<\/jats:styled-content> infection.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.12583","type":"journal-article","created":{"date-parts":[[2014,6,9]],"date-time":"2014-06-09T07:08:10Z","timestamp":1402297690000},"page":"1216-1220","source":"Crossref","is-referenced-by-count":69,"title":["Premature newborns with fatal intrauterine herpes simplex virus\u20101 infection: first report of twins and review of the literature"],"prefix":"10.1111","volume":"29","author":[{"given":"M.","family":"Pichler","sequence":"first","affiliation":[{"name":"Department of Dermatology, Venereology and Allergology Academic Teaching Department of Innsbruck Medical University Central Teaching Hospital of Bolzano\/Bozen Bolzano\/Bozen Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Staffler","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit Central Teaching Hospital of Bolzano\/Bozen Bolzano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Bonometti","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Allergology Academic Teaching Department of Innsbruck Medical University Central Teaching Hospital of Bolzano\/Bozen Bolzano\/Bozen Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Messner","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit Central Teaching Hospital of Bolzano\/Bozen Bolzano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Deluca","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Allergology Academic Teaching Department of Innsbruck Medical University Central Teaching Hospital of Bolzano\/Bozen Bolzano\/Bozen Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Thuile","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Allergology Academic Teaching Department of Innsbruck Medical University Central Teaching Hospital of Bolzano\/Bozen Bolzano\/Bozen Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Kluge","sequence":"additional","affiliation":[{"name":"Department of Pathology Central Teaching Hospital of Bolzano\/Bozen Bolzano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Schmuth","sequence":"additional","affiliation":[{"name":"Department 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