Occult genital herpes presenting as an endometrial infection detected at delivery: a report of two cases

Background: The prevalence and clinical implications of asymptomatic genital herpes remain elusive.
Objective/aim: We report two cases of clinically asymptomatic intrautcrine herpes simplex virus II (HSV-II) infection in
order to discuss their pathological significance and demonstrate the potential utility of specific DNA probes and antibodies.
Methods: Standard histology, immunohistochemistry (IHC) and in situ hybridization (ISH) were applied to formalin-tixed.
paraffin-em bedded lissue sections of curettage specimens from women presenting deciditalised fragments retention after
normal delivery.
Results: Hisiological analysis revealed a focal clearing of endometrial epithelial cell nuclei, suggesting a viral etiology. ISH
and IHC with differetit DNA probes or antibodies confirmed the diagnosis of HSV-II infection at the time of specimen
collection. Clinical signs of muco-cutaneous involvement in the mothers and of neonatal HSV infection were not observed.
Conclusion: These findings suggest that intrauterinc HSV-II infection is not always associated with disease. The IHC and
ISH methods can be helpful to a.ssess the diagnosis of HSV-II intrauterine infections in the presence of optically clear
cndotTietrial nuclei. Whether or not such HSV-II occult infection may be associated with viral shedding and risk of sexual
transtnission was not evaluated in the present study. © 1997 Elsevier Science B.V.