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Disseminated Neonatal Herpetic Infection Simulating Abusive Anal Trauma

NCJ Number
235814
Journal
Journal of Forensic Sciences Volume: 56 Issue: 4 Dated: July 2011 Pages: 1058-1061
Author(s)
Michael Panella, M.D., J.D.
Date Published
July 2011
Length
4 pages
Annotation
This case highlights the importance of considering occult neonatal herpes with associated perianal ecchymosis when presented with possible abusive anal trauma in a newborn infant.
Abstract
Potential simulators of premortem trauma present problems of misinterpretation and possible false accusations of caregivers. A case of unsuspected neonatal herpes is reported with associated perianal ecchymosis that raises the possibility of sexual abuse. The decedent was an 8-day-old newborn infant who was born by Cesarean section and treated for 5 days postdelivery for sepsis. The newborn infant was discharged home but returned 2 days later with probable sepsis and new onset of perianal hemorrhage. She died 1 day later with autopsy, revealing neonatal disseminated herpetic infection with early anal involvement consisting of microscopic ulcerations with leukocytoclastic-like vasculitis and rare viral cytopathic changes. These histological changes produced grossly appearing anal ecchymosis with an absence of typical herpetic vesiculopapular lesions, which simulated abusive trauma. (Published Abstract)