Which type of HSV is more likely to cause herpetic keratitis in neonates?

Herpetic keratitis in neonates is most commonly associated with HSV-2. This is primarily due to the manner in which neonates are often exposed to the virus. During delivery, if the mother has an active genital HSV-2 infection, there is a risk of transmission to the newborn. The virus can infect the eye and lead to keratitis, which may result in severe complications if not treated promptly.

While HSV-1 can also cause ocular infections, it is more frequently associated with herpetic keratitis in older children and adults, typically following oral or facial lesions. On the other hand, HSV-3 (varicella-zoster virus) and HSV-4 (Epstein-Barr virus) are not commonly linked with herpetic keratitis presentations at all.

Understanding the specific viral types and their common modes of infection is critical in managing and preventing complications in neonates. The focus on HSV-2 in this context highlights its significant role in neonatal herpetic infections, particularly concerning keratitis.