PULMONARY HERPES-SIMPLEX IN BURNS PATIENTS

In this study we aimed to determine the incidence of herpes simplex vi rus (HSV) in the lungs of burns patients, and its association with the presence of adult respiratory distress syndrome (ARDS) and pneumonia. Haematoxylin and eosin (H&E), and immunohistochemical (IHC) staining for HSV was performed on lung tissue from 54 patients who had died fol lowing burn injury and from nine control cases, Polymerase chain react ion (PCR) for HSV deoxyribonucleic acid (DNA) was performed on a subse t both of burns cases and controls, No viral inclusions were detected in H&E sections, but 50% of the burns cases were positive for HSV by I HC staining; no control eases were positive, Nuclear and cytoplasmic i mmunopositivity for HSV was seen in macrophages and epithelial lining cells, HSV was strongly associated with ARDS (p=0.007), but not with p neumonia (p=0.577). The relative risk of HSV infection was higher for cases with ARDS (2.21) than for those with pneumonia (1.26). PCR for H SV DNA was positive in three out of five burns cases, and in one out o f five control cases. Immunohistochemical staining is more sensitive f or the detection of herpes simplex virus than haematoxylin and eosin s taining for detection of viral inclusions, Burns cases have a high inc idence of pulmonary herpes simplex virus infection, Polymerase chain r eaction results may not be fully representative due to problems of tis sue necrosis postmortem, Pulmonary herpes simplex virus is strongly as sociated with adult respiratory distress syndrome and the two may be c ausally linked, Early detection and treatment of pulmonary herpes simp lex virus in burns patients may reduce pulmonary complications and mor tality.