\s=b\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. (Am J Dis Child 1981;135:750-753) Bacterial and fungal infections are recognized as important causes of the morbidity and mortality asso¬ ciated with burns.1 In contrast, there are few reports of viral infections in burn patients. Most of the reported cases have been due to herpesviruses, including cytomegalovirus (CMV) and herpes simplex virus (HSV), but there are only limited data available on the frequency of these infections in burn patients.-" The source of these viral infections, whether primary infec¬ tions or reactivation of latent infec¬ tions, has not been determined. The present study was undertaken to define the type and frequency of viral infections in pediatrie burn patients.
MATERIALS AND METHODS
Study PlanThe patients included in these studies were children admitted to the Cincinnati Shriners Burns Institute. Many of these children were treated for acute burns at other hospitals and transferred to the burn hospital after their conditions had stabi¬ lized. The first part of the study was a retrospective survey of serum for viral antibodies. Serum that had been collected from 40 children at approximately monthly intervals and frozen at -20°C was used for this study. The study was extended on the basis of the observations made in the first part. The second part of the study was a prospective survey of viral excretion and the development of serum antibodies in 24 children. Specimens for viral culture and antibody testing were collected at monthlyintervals. Only children who were followed up for at least two months were included in either of these two studies. Definitions used ¡n the study were as follows: (1) Fever was a temperature of 38°C or greater. (2) Hepatitis was the increase in the SGOT value above the normal range for our labo¬ ratory on two consecutive determinations one week or longer after the initial burn.(3) Lymphocytosis was an increase on three consecutive determinations in the percent¬ age of lymphocytes or the absolute cell count above the mean for the patient's age.Patients were c...
