Viral infections in pediatric burn patients

Bacterial and fungal infections are frequent complications of burns, but the frequency of viral infections has not been defined. In a retrospective survey of serum for viral antibodies in pediatric burn patients, 22% had fourfold increases in antibodies to cytomegalovirus (CMV); 8% had increases to herpes simplex virus and to Epstein-Barr virus; and 5% had increases to varicella-zoster virus. None of the patients had evidence of adenovirus or hepatitis B virus infection. On the basis of these observations, a prospective study of viral infections, using both serologic and viral culture techniques, was performed. This study showed that in 33% of the children CMV infection developed; in 25%, herpes simplex infection; and in 17%, adenovirus infection. In all of the most severely burned children CMV infections developed, and both primary and reactivation infections were observed. Unexplained fevers are common in pediatric burn patients, and this study shows that some of these may be due to CMV infection.