This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pediatrics
In neonatal herpes, true is - 
Select and explain. 
A. Caused by HSV-II, B. Hepatosplenomegaly is diagnostic, C. Spontaneous recovery occurs, D. If not treated, disseminates
A: Caused by HSV-II
Answer: A: Caused by HSV-II 
Explanation: Ans. is 'a' i.e., Caused by HSV-II Neonatal herpes infection o It is commonly caused by HSV-2 (70% cases are caused by HSV-2 and 30% caused by HSV-1) Case fatality rate exceeds 60% in untreated neonatal herpes. The infection is acquired by passage through an infected genital tract at bih. The greatest risk i.e., 50% transmission rate occurs with a primary infection in the mother at time of delivery (because the antibodies have not yet developed, there is more virus present and no antibody transfer). With recurrent herpes at term, the transmission rate is only 8% or less. o Neonatal infections present on the 6th day postpaum. There are three major categories. Localized skin, eye and mouth infection CNS infection Dissenminated infection The hallmark of neonatal HSV infection - the vesicular, ulcerative skin lesions occur in only 30-43% children. If left untreated the virus dissenmination can occur to internal organs which is the most serious complication of neonatal herpes.