Herpesviradae infections in severely burned children.

Abstract

OBJECTIVE:

Burn-related immunosuppression can promote human herpesviridae infections. However, the effect of these infections on morbidity and mortality after pediatric burn injuries is unclear.

METHODS:

We retrospectively analyzed pediatric patients with burns ≥10% of the total body surface area (TBSA) who were admitted between 2010 and 2015. On clinical suspicion of a viral infection, antiviral therapy was initiated. Viral infection was confirmed via Tzanck smear, viral culture, and/or PCR. Study endpoints were mortality, days of antiviral agent administration, type of viral test used, type of viral infection, and length of hospitalization.

RESULTS:

Of the 613 patients were analyzed, 28 presented with clinically diagnosed viral infections. The use of Tzanck smears decreased over the past 5 years, whereas PCR and viral cultures have become standard. Patients with viral infections had significantly larger burns (53±15% vs. 38±18%, p<0.001); however, length of stay per TBSA burn was comparable (0.5±0.4 vs. 0.6±0.2, p=0.211). The most commonly detected herpesviridae was herpes simplex virus 1. Two patients died due to sepsis, which was accompanied by HSV infection. The mortality rate among all patients (2.7%) was comparable to that in the infected group (7.1%, p=0.898). Acyclovir was given systemically for 9±8days (N=76) and/or topically for 9±9days for HSV (N=39, combination of both N=33). Ganciclovir was prescribed in three cases for CMV.

CONCLUSIONS:

Viral infections occur more commonly in patients suffering from larger burns, and HSV infections can contribute to mortality.

• Authors: Paul Wurzer, Megan R Cole, Robert P Clayton, Gabriel Hundeshagen, Omar Nunez Lopez, Janos Cambiaso-Daniel, Raimund Winter, Ludwik K Branski, Hal K Hawkins, Celeste C Finnerty, David N Herndon, Jong O Lee
• Journal: Burns : journal of the International Society for Burn Injuries (Burns) Vol. 43 Issue 5 Pg. 987-992 (Aug 2017) ISSN: 1879-1409 [Electronic] Netherlands
• PMID: 28420570 (Publication Type: Journal Article)
• Copyright: Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Chemical References

• Antiviral Agents

Topics

• Adolescent
• Antiviral Agents (therapeutic use)
• Burns (mortality, therapy, virology)
• Child
• Child, Preschool
• Female
• Herpesviridae (isolation & purification)
• Herpesviridae Infections (diagnosis, drug therapy, etiology)
• Humans
• Infant
• Male
• Polymerase Chain Reaction
• Retrospective Studies
• Risk Factors
• Sepsis (virology)
• Virology (methods)
• Wound Infection (diagnosis, drug therapy, virology)