Herpes simplex virus necrotising pneumonia in an apparently immunocompetent patient: a postmortem diagnosis

Our case describes an apparently immunocompetent patient in the intensive care unit (ICU) with a non-resolving pneumonia despite antibiotic treatment. On bronchoalveolar lavage (BAL), a positive herpes simplex virus (HSV) PCR was obtained, which was left untreated because of the absence of underlying immunosuppression. However, postmortem analysis revealed a necrotising pneumonia due to massive HSV reactivation. Our case highlights the importance of HSV as a potential pathogen in the ICU, even in apparently immunocompetent individuals. Moreover, this article underscores the absence of clear guidelines in the current literature regarding HSV management in critically ill patients.