Cathryn Sabulski, MD
Riham Alwan, MD
Wendy Pomerantz, MD
Cincinnati Children’s Hospital Medical Center
Four day old former full term female presenting with mouth lesions. Born at 40 week old via NSVD to a GBS negative mother. Mother denies any infections during pregnancy. No maternal history of HSV. Maternal grandmother has been helping with care and is currently on valcyclovir suppression for oral HSV. Taking two ounces of pumped breast milk every two to three without issue. Excellent urine output and normal stooling.
On the night prior to presentation, mother noted lesions on patient’s posterior oropharynx, so brought her in for evaluation. Otherwise no ill symptoms, no changes in behavior. No other lesions or rashes.
What are the pharyngeal lesions in this newborn?
A. Neonatal herpes simplex virus
B. Viral stomatitis (e.g., Coxsackie virus)
C. Oral candidiasis
D. Epstein pearls
E. Bednar’s apthae