Acyclovir Therapy for Eczema Herpeticum in Infants

To the Editor.—  We were very interested in the article by Jawitz et al¹ concerning intravenous acyclovir treatment of eczema herpeticum (EH) in a 9-month-old female infant. To date, we have treated four infants with severe EH (Kaposi's varicelliform eruption²), ranging from 7 to 14 months of age, with the same regimen. Two of our cases have been reported previously^3,4; all four involved primary herpetic infections caused by herpes simplex virus 1. Fever and general symptoms disappeared between 12 and 72 hours after initiation of acyclovir therapy. Herpes simplex virus 1 was found in eroded lesions during the first three to four days of treatment, but no new vesicles were noted. From our experience, we would like to emphasize some points: (1) As soon as EH is suspected on clinical and cytologic grounds, systemic antistaphylococcal antibiotics must be administered in association with acyclovir therapy; one of our