Our client was born healthy. Over the following weeks, he was seen by his pediatric providers multiple times for a persistent skin rash that would not improve. His mother’s known history of herpes simplex virus, combined with a rash that lingered for more than a week across multiple visits, should have prompted HSV testing far sooner than it did.
By the time a treating physician finally ordered the appropriate test, the infection had already progressed. Our client was rushed to the hospital, where he was diagnosed with HSV meningoencephalitis. The infection caused seizures and permanent brain injury, leaving him unable to move his limbs, hold up his head, or communicate.
Why This Case Matters
A mother's documented history of herpes simplex virus is not a minor detail buried in a chart. It is a red flag that should shape how providers evaluate a newborn presenting with a persistent rash. When that history is paired with a rash that fails to resolve over more than a week of repeated visits, the standard of care calls for HSV testing, not continued observation.
This case raised serious questions about whether our client's providers connected information that was available to them from the start. The delay in testing was not a matter of missing information. It was a matter of failing to act on it. That delay allowed a treatable infection to progress into a life-altering brain injury.
