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September 20, 1971

Herpetic Pneumonia in Alcoholic Hepatitis

Author Affiliations

Los Angeles

JAMA. 1971;217(12):1703. doi:10.1001/jama.1971.03190120069018

To the Editor.—  Since the isolation of herpes simplex virus from the lungs of a 12-year-old girl with Stevens-Johnson syndrome in 1949,1 occasional cases of herpetic tracheobronchitis or pneumonia have been noted. However, herpetic pneumonia is rare in adults, and in only three cases has there been satisfactory morphological and virological evidence of such infection.2-4 Herpetic infection of the lower respiratory tract has usually been associated with immunosuppression or extensive burns. The present case was associated with primary hepatic disease.

Report of a Case.—  A 33-year-old woman had been hospitalized elsewhere ten days earlier because of a two-week history of epigastric pain, anorexia, weakness, and jaundice, treated with antibiotics, whole blood, and steroids. Upon admission here, she was a mildly obtunded, afebrile, deeply icteric, seriously ill woman with spider angiomas and palmar erythema, and a history of alcoholism. There were no external lesions suggestive of herpes simplex. Dullness