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January 18, 1980

Primary Herpes Simplex Infection Following Mouth-to-Mouth Resuscitation

Author Affiliations

From the Departments of Dermatology (Dr Hendricks) and Medicine (Dr Shapiro), Johns Hopkins Hospital, Baltimore.

JAMA. 1980;243(3):257-258. doi:10.1001/jama.1980.03300290039020

CARDIOPULMONARY resuscitation (CPR) is a lifesaving technique that has been widely taught to medical and allied health personnel. Standard references on CPR have emphasized patient benefits without discussing risks or necessary follow-up precautions for the person performing or receiving resuscitation. We report a case of a primary herpes simplex infection acquired by a physician from mouth-to-mouth resuscitation of a patient with herpes simplex pneumonia.

Report of a Case  A 27-year-old male physician performed mouth-to-mouth resuscitation on a 51-year-old debilitated woman in respiratory arrest. Herpes simplex subsequently grew from a culture of her sputum. At autopsy, discrete ulcers containing multinucleated giant cells were seen on her tongue, trachea, and esophagus. An organizing pneumonia was found in both lungs, and herpes simplex, type 1, was cultured from lung tissue.Three days after the resuscitation, the physician noted tender, submental, and cervical lymphadenopathy. Discrete, painful, papulovesicular lesions appeared over his beard area on