Herpesvirus Infection in Burned Patients

Herpesvirus hominis infection of healing partial-thickness burns occurred in six patients. Two of these died with disseminated herpetic infection. They had necrotizing hepatic and adrenal lesions, similar to those that have been described in herpetic infection in neonates without neutralizing antibody. Serologic studies demonstrated lack of neutralizing antibodies to herpesvirus antigen before and after development of herpetic infection in an additional patient who died with disseminated lesions. The viral infection may have been primary, but the possibility of a reactivated infection that resulted in extensive disease due to a post-traumatic immunologic defect is not excluded. Herpetic burn-wound infection is analogous to the extensive herpetic infection that occurs in eczematous children — eczema herpeticum. Fatal pseudomonas burn-wound sepsis may originate in areas of herpetic burn-wound infection, but the frequency of this sequence is unknown.