Acute Necrotizing Pneumonia from Herpes Simplex Virus

Herpes simplex virus (HSV) pneumonia has been well-described in immunocompromised individuals, especially hematopoetic cell transplant recipients prior to implementation of acyclovir prophylaxis, as well as intubated patients in the intensive care unit (ICU)1-3. Nevertheless, diagnosis of Herpes simplex virus pneumonia in the ICU remains elusive and is confounded by frequent shedding of the virus in the setting of critical illness, without frank organ disease4. We describe the unusual case of an ICU patient with no previous history of immunosuppression, who developed acute necrotizing pneumonia from Herpes simplex virus.