HERPES-SIMPLEX DISSEMINATION FOLLOWING GLUCOCORTICOIDS FOR UPPER AIRWAY-OBSTRUCTION IN AN ADOLESCENT GIRL

A previously healthy adolescent female suddenly developed a severe feb rile pharyngitis and impending upper airway obstruction. Her Monospot( R) test was positive, and her throat culture grew group A beta-hemolyt ic streptococcus. After treatment with antibiotics and glucocorticoids , she developed a fulminant course dominated by disseminated intravasc ular coagulation and hepatic necrosis. At autopsy, herpes simplex viru s type-1 was cultured from lung, liver, and spleen tissue. We believe this is the first report of disseminated herpes simplex infection afte r steroid use for upper airway obstruction.