cHerpes simplex virus (HSV) pathogenesis in mice differs based on availability of the principal entry receptors herpesvirus entry mediator (HVEM) and nectin-1 in a manner dependent upon route of inoculation. After intravaginal or intracranial inoculation of adult mice, nectin-1 is a major mediator of neurologic disease, while the absence of either receptor attenuates disease after ocular infection. We tested the importance of receptor availability and route of infection on disease in mouse models of neonatal HSV. We infected 7-day-old mice lacking neither or one principal HSV receptor or both principal HSV receptors with HSV-2 via a peripheral route (intranasal), via a systemic route (intraperitoneal), or by inoculation directly into the central nervous system (intracranial). Mortality, neurologic disease, and visceral dissemination of virus were significantly attenuated in nectin-1 knockout mice compared with HVEM knockout or wild-type mice after intranasal inoculation. Mice lacking both entry receptors (double-knockout mice) showed no evidence of disease after inoculation by any route. Nectin-1 knockout mice had delayed mortality after intraperitoneal inoculation relative to wild-type and HVEM knockout mice, but virus was able to spread to the brain and viscera in all genotypes except double-knockout mice. Unlike in adult mice, HVEM was sufficient to mediate disease in neonatal mice after direct intracranial inoculation, and the absence of HVEM delayed time to mortality relative to that of wild-type mice. Additionally, in wild-type neonatal mice inoculated intracranially, HSV antigen did not primarily colocalize with NeuNpositive neurons. Our results suggest that differences in receptor expression between adults and newborns may partially explain differences in susceptibility to HSV-2. H erpes simplex virus (HSV) causes neonatal infection in about 1 in 3,200 live births in the United States (1). More than half of infants with neonatal HSV disease have disseminated disease or encephalitis (2), which, despite effective antiviral treatment, results in the deaths of more than 25% of those with disseminated disease and in neurologic morbidity in more than two-thirds of survivors of encephalitis (3). Relative to other populations infected with HSV, newborns have the highest rates of dissemination and central nervous system (CNS) disease (4). Although differences in immune responses from those of adults have been implicated, precise reasons for the increased severity of disease in infants remain unknown (5).Infection of susceptible human and mouse cells by HSV requires binding of the viral glycoprotein gD with one of its cell surface receptors (6, 7). HSV gD binds to three general classes of surface receptors, including herpesvirus entry mediator (HVEM), nectin-1 and Ϫ2, and specific sites in heparan sulfate (7). Of these, HVEM and nectin-1 appear to mediate viral entry most efficiently in both humans and mice (8, 9). The mouse receptors are orthologous to the human receptors, and HSV disease in mice resembles that i...