Home Emergency Medicine Herpes Simplex Virus Can Mimic Premature Rupture of Membranes

Herpes Simplex Virus Can Mimic Premature Rupture of Membranes

Case vignette describes woman with leakage of clear fluid, despite normal amniotic fluid volume

THURSDAY, July 9, 2015 (HealthDay News) — Unique presentation of herpes simplex virus infection in pregnancy can be misdiagnosed as premature rupture of membranes (PROM), according to a case report published in the August issue of Obstetrics & Gynecology.

Christina N. Cordeiro, M.D., from the Johns Hopkins Hospital Bayview Medical Center in Baltimore, and colleagues described the case of a 21-year-old woman, gravida 1 para 0, at 25 5/7 week of gestation who was admitted for suspected preterm PROM.

The authors note that the patient had positive findings on pooling, ferning, and Nitrazine tests. In a blue dye test, her cervix was bluish with white plaques. A normal amniotic fluid index of 11.7 cm was identified on an ultrasound performed on admission, although the patient reported continued leakage of clear fluid. The patient’s discharge decreased on hospital day three and ceased completely on hospital day eight; amniotic fluid index was normal on hospital day seven. Examination for pooling, ferning, and Nitrazine were negative on day eight, and the blue dye tampon test was negative for ruptured membranes on day 10. The patient was discharged home; after discharge, the Pap test results returned and showed herpes simplex virus infection.

“The diagnosis of preterm PROM should be constantly reevaluated in the setting of a normal amniotic fluid volume,” the authors write.

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