Article Text

  1. J. W.L. Chou1,
  2. S. H. Wootton1,
  3. C. Yong1
  1. 1Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC.


Background Herpes zoster (HZ), a disease of the immunocompromised and the elderly, can also occur in healthy children. Case series and surveillance studies have consistently identified early childhood varicella (VZV) infection (age < 1 year old) as a risk factor for HZ. Commonly involving the left thoracic dermatomes, HZ can also present with various distributions of rash. Intravenous acyclovir therapy, beneficial in immunocompromised patients with HZ, has also been used in healthy children with complications of the disease.

Case Description We present a case of HZ in a 16-year-old immunocompetent male whose primary VZV infection occurred when he was 8 years old. His course was complicated by an unusual rash involving > 1 dermatome, viral meningitis (confirmed by PCR), and renal insufficiency following a 3-day course of acyclovir.

Implications HZ can occur in healthy children of all ages, including those whose primary VZV infection occurs at a later age. Even short courses of acyclovir therapy in children with normal renal function may lead to acute renal failure. Physicians should carefully assess the benefits and risks of acyclovir for HZ in healthy children. If it is initiated, renal function should be monitored closely.

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