Introduction: Sepsis is the leading cause of death in severely burned patients. Bacterial and fungal infections are easily recognized and isolated while viral infections are often insidious. Herpes simplex virus (HSV) infection of the head and neck in burn patients is relatively common secondary to the profound immunosuppression experienced after severe burn injury. The immunosuppression renders patients susceptible to both primary HSV infection or allows the reactivation of latent HSV infection. We report a rare case of a 14-month old female with an 80% total body surface area (TBSA) scald burn complicated by HSV type 2 infection. The patient was transferred to our tertiary care center three days after her initial injury. To our knowledge, this is the first account of such a fulminant HSV type 2 infection in a severely burned patient. She presented with 50% TBSA deep partial thickness and 30% TBSA full thickness injuries. She underwent three operative interventions prior to the eruption of multiple vesicular lesions on previously healed donor sites and burn wounds. By the fifteenth day after her injury, the infection resulted in complete graft loss, donor site conversion to full thickness wounds, visceral dissemination to the liver, lungs and adrenal gland and death. Tzanck smear of vesicular lesions is a quick method for the identification of patients with HSV, while immunofluorescence testing with anti-HSV monoclonal antibodies identifies the specific virus. Treatment of HSV infection includes use of systemic and topical acyclovir, meticulous wound care, and efforts to prevent nosocomial spread.