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Herpetic Infections in Pediatric Burn Patients: A Retrospective Analysis from a Tertiary Children Burn Center
Daria Oborkina 1, Ludmila Budkevich 1, Mariia Kozmova 2, Ghena Abou Eljadayel 3
1 Veltischev Research and Clinical Institute for Pediatrics and Pediatric Surgery of the Pirogov Russian National Research Medical University
2 First Moscow State Medical University named after I.M. Sechenov (Sechenov University)
3 Patrice Lumumba Peoples’ Friendship University of Russia (RUDN University), Department of Pediatric Surgery, Moscow, Russian Federation
Background:
Thermal injuries in children disrupt cutaneous and mucosal barriers and impair immune function, increasing susceptibility to opportunistic pathogens, including herpesviruses. These infections may complicate recovery and extend hospitalization.
Objective:
To assess the incidence, virological spectrum, and clinical implications of herpetic infections in pediatric patients with acute burns.
Methods:
A retrospective review was conducted at the Children's Burn Center in Moscow, including children admitted with burn injuries between January 2020 and December 2024. Patients with persistent fever (>38.5°C for over 48 hours) underwent PCR testing for herpesviruses. Demographic, clinical, surgical, and laboratory data were analyzed, including viral-bacterial associations. Outcomes in patients with confirmed herpesvirus infection were compared to those without.
Results:
Among 257 pediatric burn patients with suspected viral infection, 172 (67%) were positive for herpesviruses: human herpesvirus 6 (HHV-6, 54%), cytomegalovirus (CMV, 27%), Epstein-Barr virus (13%), and herpes simplex virus types 1 and 2 (6%). No significant differences were observed in median age (16 months, IQR: 12–22), total body surface area burned (7%, IQR: 5–10), or surgical intervention rates between infected and non-infected groups. However, patients with herpetic infections had notable hematologic changes, increased frequency of viral-bacterial co-infection—most commonly Staphylococcus (67%), Streptococcus (15%), and Klebsiella (13%)—and significantly longer hospital stays (P < 0.05).
Conclusion:
Herpetic infections are common in pediatric burn patients and are associated with secondary bacterial infections and prolonged hospitalization. Early virological screening and targeted management may be critical in improving outcomes in this high-risk population.