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During the Emergency Department evaluation of a well-appearing neonate with fever, should empiric acyclovir be initiated?

The Journal of Emergency Medicine Dec 05, 2017

Bruno E, et al. - In view of significant morbidity and mortality associated with Herpes simplex virus (HSV) infection in the neonatal period, researchers searched for a standardized approach regarding when to initiate testing and treatment for HSV infection. Available research suggested strongly considering HSV infection in the febrile neonate if age is < 21 days, or if presenting with concerning clinical features. They recommend initiation of empiric treatment with high-dose acyclovir if testing is performed. Additional research is suggested to assess which cases mandate evaluation and treatment for HSV, and to better define treatment protocols.
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