ABSTRACT
This report describes a newborn with recurrent herpes simplex meningoencephalitis
despite vigorous antiviral therapy. The course is unusual in that the presenting symptom
was hoarseness. Despite probable adequate acyclovir levels in the spinal fluid, a
second episode or progression of herpetic encephalitis occurred, suggesting impairment
of host defenses, particularly cellular immunity. This episode was treated with both
acyclovir and vidarabine. Pharmacokinetics of the antiviral therapy and immune responses
are discussed.
