A report on a case of herpes simplex disseminated skin infection

Herpes simplex clinical manifestations are in the form of vesicular eruptions on erythemateus base. The virus can remain latent within sensory nerve ganglions following the initial infection and be reactivated in some cases such as intracranial surgery, dental surgery, stress and excitements. Systemic or disseminated infection occurs in immune-deficient patients and sometimes in healthy individuals. In Previous studies, in most of the disseminated infection cases, visceral organs involvement has been mostly observed while skin involvement has been reported just in one case. Thus, our patient was the second case with herpes simplex disseminated skin infection. Case: The patient was a 38 year-old man who underwent craniotomy surgery due to epidural hematoma following car accident and head trauma. Almost 10 days after the surgery, the patient developed disseminated vesicular eruptions in erythemathous base which initially appeared in the face, head, and then in body and extremities. Fever was detected 5 days before the development of eruptions. Other than anemia and leucocytosis, there were no other notable points in the systemic examination and lab tests. For patient skin biopsy was taken with an impression of herpes simplex, mulocum contagiosum and a lower probability for bullouse diseases. In the skin biopsy, intra-epidermal vesicles and extensive epidermal necrosis with multinucleated giant cells and intra-nuclear objects were observed. A plethora of neutrophilic cells inside the vesicles and inflammatory cell infiltration in the underlying debris were seen. Based on the pathology report, infection with herpes simplex hominis was confirmed. Disseminated skin infection with herpes simplex can be observed even in healthy people with no background.