A neonate with rash and fever

• Neonatal skin lesions are difficult to distinguish by appearance alone, emphasizing the importance of history, vital signs, clinical examination, and laboratory results in each case to narrow the differential diagnosis. • For herpes simplex virus (HSV), treatment with acyclovir initiated at the time of suspicion of HSV is paramount; there may be substantial morbidity and mortality despite antiviral drug therapy, and this may be worsened when treatment is delayed.