Two cases of neonatal herpes encephalitis that showed an apparent uneventful recovery had concurrent severe, diffuse cerebral imaging abnormalities, in a report from Gillette Children's Specialty Healthcare, St Paul, and Children's Hospital, Minneapolis, MN. Despite prompt treatment with acyclovir and a favorable convalescence, imaging revealed severe diffuse cerebral infarction, discordant with the clinical findings. The prognosis was ultimately malignant. 
COMMENT. The initial discordance of clinical response to acyclovir and brain imaging abnormalities indicates the need for serial CT or MRI during treatment of neonatal herpes encephalitis.