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Herpes zoster in immunocompetent and immunocompromised Japanese children
1Department of Pediatrics, Tokyo Metropolitan Komagome Hospital, Japan. takyamnd-k@komagome-hospital.bunkyo.tokyo.jp
Insights
Varicella in the first year of life is a risk factor for herpes zoster in immunocompetent children. Pediatric herpes zoster can be severe even in children without immunosuppression.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Investigating epidemiological features of herpes zoster in pediatric patients.
- Comparing outcomes in immunocompetent versus immunocompromised children.
Purpose of the Study:
- To confirm epidemiological characteristics of herpes zoster in children.
- To assess risk factors and disease presentation in pediatric herpes zoster patients.
Main Methods:
- Retrospective review of 92 pediatric herpes zoster cases (1981-1998).
- Analysis of age at onset, varicella interval, lesion distribution, and complications.
- Comparison between immunocompetent and immunocompromised pediatric groups.
Main Results:
- Mean age of zoster onset was similar in both groups (8.5 vs 9.7 years).
- Varicella onset was earlier in immunocompetent children (1.6 vs 4.6 years).
- Complications like dissemination, meningitis, and facial palsy occurred in children without underlying disease.
Conclusions:
- Varicella in infancy is a confirmed risk factor for herpes zoster in immunocompetent children.
- Pediatric herpes zoster is not always mild, even in immunocompetent individuals.
Background:
To confirm epidemiological features of herpes zoster among children with or without immunosuppression, herpes zoster patients who had presented to this hospital were retrospectively investigated.
Methods:
Medical records were reviewed for the 92 cases of pediatric herpes zoster patients diagnosed during the period from 1981 to 1998. The age at onset of herpes zoster and of varicella, the interval between varicella and zoster, the dermatomal distribution of herpes zoster and complications were compared between immunocompetent and immunocompromised children.
Results:
The mean age at onset of zoster in immunocompetent children was 8.5 +/- 4.0 years and in immunosuppressed children was 9.7 +/- 3.8 years. The age at onset of varicella was significantly lower (1.6 +/- 1.8 years) in immunocompetent than in immunosuppressed children (4.6 +/- 2.7 years). The interval between varicella and zoster was 6.2 +/- 3.2 years in immunocompetent children. More than 80% of patients with acute leukemia or malignant lymphoma had herpes zoster within 2 years after diagnosis of malignancy. Lesions of herpes zoster were most frequently found in the thoracic nerve regions. Five of 11 zoster patients with cutaneous dissemination, three of five zoster patients having aseptic meningitis and three of four patients complicated facial palsy were children without underlying disease.
Conclusions:
The present study confirmed that varicella in the first year of life was a risk factor in immunocompetent children, as reported previously. Herpes zoster in children without immunosuppression was found not to be as mild as generally accepted.