Herpes Zoster as first manifestation of varicella-zoster virus infection in a healthy child

  • Catarina Carrusca Paediatric Service of Hospital Vila Franca de Xira
  • Raquel Machado Paediatric Service of Hospital Vila Franca de Xira
  • Carolina Albuquerque Paediatric Service of Hospital Vila Franca de Xira
  • Florbela Cunha Paediatric Service of Hospital Vila Franca de Xira
Keywords: Herpes zoster ophtalmicus, serologic tests, asymptomatic infections, preschool child

Abstract

Herpes zoster (HZ) results from reactivation of varicella-zoster virus. HZ’s incidence increases with age and although rarely, it can affect healthy children. We describe a previously healthy 29-months-old girl with herpes zoster ophtalmicus. She presented with fever and a painful vesicular skin rash covering the right forehead. She had no past history of clinical varicella or varicella vaccination, although she had household contact with varicella at two months-old. Serologic varicella zoster virus tests were initially negative, but seroconversion occurred 8 weeks later. Polymerase chain reaction assay of the vesicles fluid was positive for the virus. Intravenous acyclovir was started and the patient recovered without sequelae. HZ may occur in an otherwise healthy young child without previous noticed varicella and with negative acute phase serology. This can be explained by the immaturity of the immune system associated with transplacental transfer of maternal antibodies affecting immunologic response to early primary infection.

References

De Freitas D, Martins E N, Adan Alvarenga L, Pavan-Langston D. Herpes zoster ophtalmicus in otherwise healthy children. Am J Ophtalmol 2006;142:393-9.

Papadopoulos A, Birnkrant A, Schwartz R, Janniger CK. Childhood Herpes Zoster. Pediatr Dermatol 2001;68:21-3.

casos clínicoscase reports

Pinchinat S, Cebrián-Cuenca AM, Bricout H, Johnson RW. Similar herpes zoster incidence across Europe: results from a systematic literature review. BMC Infect Dis. 2013;13:170.

Gershon A. Varicella-Zoster Virus Infections. Pediatr Rev 2008;29:5-10.

Long S, Prickering L, Prober S. Principles and practice of Pediatric Infectious Diseases. 3rd ed. Churchill Livingstone; 2008.

Leung J, Harpaz R, Baughman A, Heath K, Loparev V, Vázquez M, et al. Evaluation of laboratory methods for diagnosis of varicella. Clin Infect Dis. 2010;51:23-32.

Soeteman M, Willems R, Busari J. Herpes zoster ophthalmicus in an otherwise healthy 2-year-old child. BMJ Case Reports. 2012;10.1136/bcr

-007015.

Kurlan J, Conelly B, Lucky A. Herpes Zoster in the First Year of Life Following Postnatal Exposure to Varicella-zoster Virus. Four Case Reports and Review of Infantile Herpes Zoster. Arch Dermatol. 2004;140:1268-72.

Dobrev H. Herpes zoster in infants. Folia Med (Plovdiv) 1994;36:45-9.

Feder H Jr, Hoss D. Herpes zoster in otherwise healthy children. Pediatr Infect Dis J. 2004;23:451-7.

Terada K, Kawano S, Yoshihiro K, Miyashima H, Morita T. Characteristics of herpes zoster in otherwise normal children. Pediatr Infect Dis J 1993;12:960-1.

Published
2016-03-16
How to Cite
Carrusca, C., Machado, R., Albuquerque, C., & Cunha, F. (2016). Herpes Zoster as first manifestation of varicella-zoster virus infection in a healthy child. NASCER E CRESCER - BIRTH AND GROWTH MEDICAL JOURNAL, 25(1), 38-41. https://doi.org/10.25753/BirthGrowthMJ.v25.i1.8828
Section
Case Reports