A toddler with burns, stomatitis, and skin graft loss

The authors report on a healthy 21-month-old toddler with 13% TBSA deep sca ld burns who was successfully grafted (take 100%). In the immediate postope rative phase, the patient developed classical aphthous stomatitis and subse quent herpes viremia leading to severe viral "graftitis". Although immediat ely administered intravenous acyclovir therapy appeared to be effective, on e third of grafts were lost and had to be replaced. The lesson from this ca se is 2-fold: Herpes infection may threaten even perfectly engrafted fresh skin transplants, and, freshly grafted or soon to be grafted burn patients should be given intravenous antiviral therapy as soon as a herpes infection is diagnosed. (C) 2000 Elsevier Science Ltd and ISBI. All rights reserved.