Eczema Herpeticum of the Child

Abstract

Two children aged 7 months with eczema herpeticum received treatment consisting of intravenous acyclovir and human plasma with a high titer of herpes simplex virus antibodies. One recovered following two recurrences, but the other died rapidly, suffering both septicemia due to Pseudomonas aeruginosa and herpetic encephalitis. In both cases, the virus involved was a herpes simplex virus type 1 (HSV 1). The various isolates obtained before, during and after treatment remained equally sen sitive to acyclovir. These observations highlight three points: (1) the unpredictable and sometimes dramatic development of eczema herpeticum in the young child; (2) the urgency of early diagnosis and treatment; (3) the role of environment in viral contamination.

Get full access to this article

View all access options for this article.

References

Monif Grg , Brunell PA , Hsiung GD Visceral involvement by Herpes simplex virus in eczema herpeticum. Am J Dis Child 1968;116:324-7.

Wheeler CE , Abele DC Eczema herpeticum, primary and recurrent. Arch Dermatol 1966;93:162-71.

Leyden JJ , Baker DA Localized herpes simplex infections in atopic dermatitis. Arch Dermatol 1979;115: 311-2.

Braunstein BL , Greer KE Treatment of eczema herpeticum with vidarabine . Arch Dermatol 1982;118: 597-8.

Swart Rnj , Vermeer BJ , Van Der Meer Jwm , et al. Treatment of eczema herpeticum with acyclovir. Arch Dermatol 1983:119:13-6.

Perrin D. , Ingrand D. , Fortier B. , et al. The use of monoclonal antibodies and restriction endonuclease cleavage of viral DNA in Herpes simplex virus typing. An Virol (Institut Pasteur) 1984;135E:111-8.

Ingrand D. , Briquet I. , Brechon JM , et al. Lack of selection by Acyclovir (ACV) therapy of highly ACVresistant HSV2 clones detected before therapy in a patient with severe genital lesions. Ann Virol (Institut Pasteur) 1984;135E:89-97.

Fortier B. , Devillechabrolle A. , Huraux JM Comparison of an ELISA technique with quantal microneutralization test for serotyping of HSV1 or HSV2 infected patients. J Virol Methods 1982;5:11-20.

Stalder H. , Oxman MN , Herrmann KL Herpes simplex virus microneutralization: a simplification of the test. J Infect Dis 1975;131:423-30.

10.

Yeager AS , Arvin AM Urbani, LJ et al. Relationship of antibody to outcome in neonatal Herpes simplex virus infections. Infect Immun 1980;29:532-8.

11.

Nahmias AJ , Dowdle WR , Schinazi RF The human herpesviruses. An interdisciplinary perspective. Elsevier North Holland Publication. Co. Amsterdam, 1981.

12.

Meyers JD , Wade JC , Mitchell CD , et al. Multicenter collaborative trial of intravenous acyclovir for treatment of mucocutaneous Herpes simplex virus infection in the immunocompromised host. Am J Med 1982;73(1A):229-35.

13.

Whitley RJ , Nahmias AJ , Soong SJ , et al. Vidarabine therapy of neonatal Herpes simplex virus infection . Pediatrics 1980;66:495-501.

14.

Hammer SM , Kaplan JC , Lowe BR , et al. Alpha interferon and acyclovir treatment of herpes simplex virus in lymphoid cell cultures. Antimicrob Agents Chemother 1982;21:634-40.

15.

Strulovitch C. , Marks MI , Soneji A. , et al. Immunotherapy and drugs in neonatal disseminated herpes simplex virus type 2 infections: a mouse model. J. Antimicrob Chemother 1979;5:437-46.