1Ilko Georgiev Bakardzhiev, 2Silvi Vicheva Georgieva-Dukova
1Medical College-Varna, Bulgaria
2Department of Clinical Medical Sciences, Faculty of Dental Medicine, Medical University-Varna, Bulgaria
ABSTRACT:
Varicella-zoster virus (VZV) is a member of the alpha-herpesvirus family, causing varicella upon primary infection and remaining latent in the nerve ganglia. Reactivation of the virus leads to herpes zoster. The disease is rare in healthy children and typically presents with mild symptoms. Three cases of herpes zoster in boys aged 9 to 12 years are reported. Two of the children had no history of clinically evident varicella or vaccination, while the third child had a history of varicella at the age of four. In all three cases, the rash was unilateral and involved the T-5 dermatome. Treatment with oral acyclovir and topical agents resulted in complete recovery. Herpes zoster in childhood is more frequently observed after a history of varicella than following vaccination. The incidence of the disease in children under the age of fourteen years old is relatively low. Reactivation of the virus is associated with a temporary decline in cell-mediated immunity. The diagnosis is usually clinical, but it can be confirmed by serological and molecular methods. Treatment involves oral acyclovir, and in immunocompromised children, intravenous administration may be required. Complications are rare, but they may be of neurological, ophthalmological, or otological origin.
KEYWORDS :
herpes zoster, children, varicella-zoster virus, varicella, acyclovir.
REFERENCES :
1) Gershon AA, Breuer J, Cohen JI, Cohrs RJ, Gershon MD, Gilden D, et al. Varicella zoster virus infection. Nat Rev Dis Primers. 2015; 1:15016.
2) Katakam B, Kiran G, Kumar U. A prospective study of herpes zoster in children. Indian J Dermatol. 2016;61(5):534.
3) Leung AKC, Barankin B. Herpes zoster in childhood. Open J Pediatr. 2015;5(1):39–44.
4) Arvin AM. Management of varicella-zoster virus infections in children. Adv Exp Med Biol. 1999;458:167–74.
5) Bieńkowski C, Talarek E, Pokorska-Śpiewak M. The clinical course of herpes zoster is similar in immunocompetent and immunocompromised pediatric patients. Res Sq. 2022.
6) Terada K, Kawano S, Yoshihiro K, Yokobayashi A, Miyashima H, Morita T. Characteristics of herpes zoster in otherwise normal children. Pediatr Infect Dis J. 1993;12(11):960–1.
7) Mitra B, Chopra A, Talukdar K, Saraswat N, Mitra D, Das J. A clinico-epidemiological study of childhood herpes zoster. Indian Dermatol Online J. 2018;9(6):383.
8) Johnson RW, Dworkin RH. Treatment of herpes zoster and postherpetic neuralgia. BMJ. 2003;326(7392):748–50.
9) Reza NR, Prakoeswa CRS, Alkaff FF. Herpes zoster following COVID-19 asymptomatic infection in children. Eur J Pediatr Dermatol. 2022;32(2):101–4.
10) Kelley A. Herpes zoster: A primary care approach to diagnosis and treatment. J Am Acad Physician Assist. 2022;35(12):13–8.
11) Nair PA, Patel BC. Herpes zoster. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.
12) Balfour HH, Kelly JM, Suarez CS, Heussner RC, Englund JA, Crane DD, et al. Acyclovir treatment of varicella in otherwise healthy children. J Pediatr. 1990;116(4):633–9.
13) Arndt KA. Adverse reactions to acyclovir: topical, oral, and intravenous. J Am Acad Dermatol. 1988;18(1 Pt 2):188–90.
14) Kang DH, Kwak BO, Park AY, Kim HW. Clinical manifestations of herpes zoster associated with complications in children. Children. 2021;8(10):845.
15) Sampathkumar P, Drage LA, Martin DP. Herpes zoster (shingles) and postherpetic neuralgia. Mayo Clin Proc. 2009;84(3):274–80.
