Herpes simplex viral pneumonia in the postthoracotomy patient.

Over a 6-month period, 6 of 54 postthoracotomy patients developed pneumonia and respiratory failure. Pneumonia was secondary to herpes simplex virus type 1 in 3 of the 6 patients. Diagnostic efforts including bronchoscopy with bronchial washing, viral cultures, and cytologic examination permitted early diagnosis and successful treatment with acyclovir. A high index of suspicion for herpes simplex pneumonia must be maintained in critically ill patients with undiagnosed pneumonia.