Pediatric Nurse Practitioner Practice Exam

Which of the following is NOT a typical presentation of neonatal disseminated herpes infection?

Hyperactive newborn with apparent spasticity Fever with grouped vesicles Multiple papules Purpuric rash acral distribution

Correct Answer:

Hyperactive newborn with apparent spasticity

Explanation:

Disseminated neonatal herpes usually presents as a sick neonate with fever and skin involvement, often with grouped vesicles on an erythematous base. The infant may also have irritability, lethargy or poor feeding, and sometimes signs of systemic spread such as a purpuric or petechial rash from coagulopathy. CNS involvement is possible, leading to seizures, irritability or altered mental status, rather than hyperactivity or spasticity. So a hyperactive newborn with apparent spasticity does not fit the typical pattern. The other presentations—fever with grouped vesicles, multiple papules representing evolving vesicles, and a purpuric acral rash—can be seen with disseminated herpes in its different manifestations.

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