Kiss and Swell

Mrs Kerry Millhouse1, Ms Rebecca Schrale2

1Royal Hobart Hospital, Hobart, Australia, 2Royal Hobart Hospital, Hobart, Australia


It is widely recognised that burn related immunosuppression can result in the infection of facial burns which in turn leads to prolonged healing and an increase in adverse outcomes (Wurzer et al: 2017). Herpes Simplex Virus, (HSV), is one such infection, and one that poses a difficult diagnosis with Herpes viruses displaying clinical features involving skin loss that can mimic the initial burn injury (Crowley: 2017). Studies suggest reactivation rates of latent HSV in facial burn injury patients being around 25% (Haik et al: 2011) whilst also recognising the possibility of primary HSV infection within this population (McGill: 2000).

The following case study discusses one such primary HSV infection which prompted a change in screening practices with the RHH, and poses the question what education should be provided to reduce infection rates of HSV within our facial burn population.


Crowley, T., and Stevenson, S., 2017, Herpes Zoster Masquerading as a Chemical Burns Secondary to Hair Dye, Journal of Burns Care, Volume 38, Issue 2, pp.580

Haik, J., Weissman, O., Demetris, S., Hadar Israeli, B., Alon, L., Tessone, A., Zmora, N., Zilinsky, I., Winkler, E., Eyal, G., Shy, S., 2011, Is prophylactic acyclovir treatment warranted for prevention of herpes simplex virus infections in facial burns? A review of the literature, Journal of Burn Care, Volume 32, Issue 3, pp.358

McGill, S., Cartotto, R., Herpes Simplex virus infection in a paediatric patient: case report and review, Burns: Journal of the International Society for Burn Injuries, Volume 26, Issue 2, pp.194

Wurzer, P., Guillory, A., Parvizi, D., Clayton R., Branski, L., Kamolz, L., Finnerty, C., Herndon, D., Lee, J., 2017, Human Herpes viruses in burn patients: A systematic review, Burns, Volume 43, Issue 1, pp.25


Registered Nurse, Tasmanian Burns Unit, Royal Hobart Hospital

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