Cutaneous herpetic infections complicating burns

Many people harbor herpes simplex virus, often with a known history of "col d sores". During the relatively immunosuppressed state associated with a se rious burn, recrudescence of such infections can occur. We report four adul ts and two children who developed severe herpetic ulceration, over the face and neck in five patients and in a partial thickness wound in one patient. Herpetic infection was diagnosed by culture and direct immunofluorescence testing and treatment was immediately instituted with systemic and topical Acylovir(R) (Zovirar, Glare Wellcome). Ulceration healed under treatment an d did not leave visible scarring in any of the patients. Although these inf ections are rapidly progressive, they respond to prompt treatment with anti viral chemotherapy. Rapidly progressive vesicles and ulceration appearing o n the face or in the wounds of burn patients should prompt immediate evalua tion for herpetic infection. (C) 2000 Elsevier Science Ltd and ISBI. All ri ghts reserved.