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April 1966

Generalized Herpes Simplex and Hypoadrenocorticism: A Case Associated With Adrenocortical Insufficiency in a Prematurely Born Male: Clinical, Virologic, Ophthalmological, and Metabolic Studies

Author Affiliations

From the departments of Pediatrics, Surgery (Division of Ophthalmology), and Preventive Medicine, School of Medicine, Western Reserve University, Cleveland. Dr. Teree is a John and Mary R. Markle Scholar in Academic Medicine.

Am J Dis Child. 1966;111(4):437-445. doi:10.1001/archpedi.1966.02090070135023

THIS REPORT presents the evaluation of a prematurely born male infant who was infected with herpes simplex virus (HSV) near or at term and who developed generalized infection with central nervous system involvement and chorioretinitis. At 4 months of age he was recognized to have adrenocortical insufficiency. His unique clinical presentation, together with the prospective accumulation of relevant ophthalmologic, virologic, and metabolic findings prompted this report.

The isolation of HSV from CSF served to help establish the pathogenesis of his eye lesions. Although the adrenal cortices of infants having generalized herpes simplex infection have been judged to be infected,1-3 functional impairment of this organ has not been recorded previously.

Report of a Case  The patient was born on March 17, 1964, after a 34-week gestation of a 21-year-old woman who had developed extensive genital herpes simplex infection, first noted 20 days prior to delivery. After meconium-stained amniotic fluid was noted

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