Complications of herpes zoster in children
First published: 19 October 2019
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi:10.1111/ped.14025
Abstract
Background
Herpes zoster (HZ) may cause complications; however, the information regarding complications of HZ in children is relatively sparse. We retrospectively reviewed cases of HZ in children and investigated the risk factors contributing to the development of complications.
Methods
A retrospective observational study was conducted at a tertiary care children's hospital in Japan. Children receiving a diagnosis of HZ between January 2010 and October 2016 were identified from electronic medical records. In this study, the following diseases were recognized as complications of HZ: bacterial skin infection, facial paralysis, meningitis, uveitis and keratitis, postherpetic neuralgia, acute retinal necrosis, pneumonia, and otitis interna. Details regarding clinical information of HZ patients with complications were described.
Results
We found 138 cases with HZ. Among these, 58 (42%) occurred in immunocompetent children and 80 cases (58%) occurred in immunocompromised children. Complications were observed in 10 cases of immunocompromised children and in 8 cases of immunocompetent children. Although secondary bacterial skin infection was the most common complication (n=6, 33.3%), severe complications such as facial paralysis (n=3, 16.7%), meningitis (n=2, 11.1%), uveitis and keratitis (n=2, 11.1%), acute retinal necrosis (n=1, 5.6%), pneumonia (n=1, 5.6%), and otitis interna (n=1, 5.6%) were observed. Patients with complications tended to have a rash on the head or neck, compared to those without complications (n=9, 50% vs n=18, 15%; P=0.001).
Conclusions
Severe HZ complications may occur in immunocompetent children. Development of a rash on the head or neck might be a risk factor for complications.
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