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. ±. 8. days (N = 76) and/or topically for 9. ±. 9. days 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.
| Original language | English (US) |
|---|---|
| Journal | Burns |
| DOIs | |
| State | Accepted/In press - 2017 |
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Keywords
- Acyclovir
- Cytomegalovirus
- Polymerase chain reaction
- Tzanck smear
- Viral cultures
ASJC Scopus subject areas
- Surgery
- Emergency Medicine
- Critical Care and Intensive Care Medicine
Cite this
Herpesviradae infections in severely burned children. / Wurzer, Paul; Cole, Megan R.; Clayton, Robert P.; Hundeshagen, Gabriel; Nunez Lopez, Omar; Cambiaso-Daniel, Janos; Winter, Raimund; Branski, Ludwik; Hawkins, Hal K.; Finnerty, Celeste; Herndon, David; Lee, Jong.
In: Burns, 2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Herpesviradae infections in severely burned children
AU - Wurzer, Paul
AU - Cole, Megan R.
AU - Clayton, Robert P.
AU - Hundeshagen, Gabriel
AU - Nunez Lopez, Omar
AU - Cambiaso-Daniel, Janos
AU - Winter, Raimund
AU - Branski, Ludwik
AU - Hawkins, Hal K.
AU - Finnerty, Celeste
AU - Herndon, David
AU - Lee, Jong
PY - 2017
Y1 - 2017
N2 - 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. ±. 8. days (N = 76) and/or topically for 9. ±. 9. days 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.
AB - 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. ±. 8. days (N = 76) and/or topically for 9. ±. 9. days 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.
KW - Acyclovir
KW - Cytomegalovirus
KW - Polymerase chain reaction
KW - Tzanck smear
KW - Viral cultures
UR - http://www.scopus.com/inward/record.url?scp=85017462902&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85017462902&partnerID=8YFLogxK
U2 - 10.1016/j.burns.2017.01.032
DO - 10.1016/j.burns.2017.01.032
M3 - Article
JO - Burns
JF - Burns
SN - 0305-4179
ER -