Pulmonary herpes simplex in burns patients

In this study we aimed to determine the incidence of herpes simplex virus (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 following burn injury and from nine control cases. Polymerase chain reaction (PCR) for HSV deoxyribonucleic acid (DNA) was performed on a subset 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 IHC staining; no control cases were positive. Nuclear and cytoplasmic immunopositivity for HSV was seen in macrophages and epithelial lining cells. HSV was strongly associated with ARDS (p=0.007), but not with pneumonia (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 HSV DNA was positive in three out of five burns cases, and in one out of five control cases. Immunohistochemical staining is more sensitive for the detection of herpes simplex virus than haematoxylin and eosin staining for detection of viral inclusions. Burns cases have a high incidence of pulmonary herpes simplex virus infection. Polymerase chain reaction results may not be fully representative due to problems of tissue necrosis postmortem. Pulmonary herpes simplex virus is strongly associated with adult respiratory distress syndrome and the two may be causally linked. Early detection and treatment of pulmonary herpes simplex virus in burns patients may reduce pulmonary complications and mortality.

This article has been cited by other articles:

				F. Werdin, H.-O. Rennekampff, H.-E. Schaller, G. Jahn, and K. Hamprecht Thymidine Kinase Sequence Analysis of Herpes Simplex Virus Type 1 Strains Present in Different Compartments in an Atypical Impetiginous Rash on the Lesional Skin of a Burn Patient J. Clin. Microbiol., September 1, 2008; 46(9): 3162 - 3164. [Abstract] [Full Text] [PDF]

				C.-E. Luyt, A. Combes, C. Deback, M.-H. Aubriot-Lorton, A. Nieszkowska, J.-L. Trouillet, F. Capron, H. Agut, C. Gibert, and J. Chastre Herpes Simplex Virus Lung Infection in Patients Undergoing Prolonged Mechanical Ventilation Am. J. Respir. Crit. Care Med., May 1, 2007; 175(9): 935 - 942. [Abstract] [Full Text] [PDF]

				A. Upadya, L. Tilluckdharry, C. D. Nagy, P. Ravichandran, and C. Manthous Endobronchial pseudo-tumour caused by herpes simplex Eur. Respir. J., June 1, 2005; 25(6): 1117 - 1120. [Abstract] [Full Text] [PDF]

				E. A Kim, K. S. Lee, S. L. Primack, H. K. Yoon, H. S. Byun, T. S. Kim, G. Y. Suh, O J. Kwon, and J. Han Viral Pneumonias in Adults: Radiologic and Pathologic Findings RadioGraphics, October 1, 2002; 22(90001): S137 - 149. [Abstract] [Full Text] [PDF]