Would you recommend against use of dupilumab for severe atopic dermatitis in a patient with a history of neonatal HSV meningitis but no history with recurrent outbreaks?

No, dupilumab may be used if the patient's atopic dermatitis remains moderate to severe with standard topical treatments. I am assuming this child has history of HSV meningitis, likely in the context of eczema herpeticum. Dupilumab lowers the risk of recurrent skin infections, including HSV.