In the immunocompromised host, HSV is capable of causing local infection, characterized by extensive local involvement (e.g., eczema herpeticum) or chronic herpetic ulcers, or widespread systemic infection, characterized by widespread mucocutaneous vesicles, pustules, erosions, and ulcerations, associated with signs of pneumonia, encephalitis, hepatitis, as well as involvement of other organ systems, usually occurring in an immunocompromised host. (See also Nongenital Herpes Simplex Virus Infection, above; Sexually Transmitted Diseases: Herpes Simplex Virus: Genital Infections.
60 to 80% of HSV-seropositive transplant recipients and patients undergoing chemotherapy for hematologic malignancies will experience reactivation of HSV. After viremia, disseminated cutaneous or visceral HSV infection may occur. Factors determining whether severe localized disease, cutaneous dissemination, or visceral dissemination will occur are not well defined.
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