Herpes zoster in a 6-month-old infant with 13-year follow-up: a retrospective case report
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Published on: July 9, 2014
Kristine J Aikenhead1, Theodore L Johnson
1Department of Clinical Sciences, National University of Health Sciences, Lombard, IL 60148, USA.
Insights
This case study shows a 6-month-old infant with herpes zoster (shingles) experienced a mild, uncomplicated case. Conservative home treatment led to full recovery with no long-term complications or recurrence over 13 years.
Area of Science:
- Pediatric Dermatology
- Viral Infections
- Case Reports
Background:
- Herpes zoster (shingles) is rare in infants.
- Infants exposed to varicella-zoster virus (chickenpox) may develop subclinical infections.
- Early childhood viral infections require careful diagnosis and management.
Purpose of the Study:
- To report a case of herpes zoster in a 6-month-old infant.
- To document the outcomes of conservative management without antiviral medication.
- To present a 13-year follow-up of the case.
Main Methods:
- A 6-month-old infant presented with a unilateral vesicular rash consistent with herpes zoster.
- Diagnosis was based on clinical presentation and history of chickenpox exposure.
- Treatment involved conservative measures including Burow solution compresses and loose dressings.
Main Results:
- The infant's rash resolved completely within two weeks.
- No sequelae, such as postherpetic neuralgia, were observed.
- Follow-up over 13 years showed no recurrence of herpes zoster.
Conclusions:
- Herpes zoster in infants is uncommon but can occur.
- Infantile herpes zoster is typically mild and lacks adult complications like postherpetic neuralgia.
- Conservative management is effective for uncomplicated cases, leading to rapid resolution and no long-term issues.
Objective:
The purpose of this report is to present a case of herpes zoster in a 6-month-old infant, conservatively managed without oral antivirals, and its 13-year follow-up, demonstrating no sequelae or recurrences.
Clinical Features:
A 6-month-old white female infant presented with a vesicular rash of the right lower extremity to a chiropractic office. The rash consisted of grouped vesicles on erythematous plaques, the characteristic herpetiform lesion, distributed in the S1 dermatome of the right lower extremity only. The infant's history was significant for exposure to chicken pox at age 1 week through siblings. Consequently, only one vesicle developed, representing subclinical chicken pox. The clinical diagnosis of herpes zoster was made.
Intervention And Outcome:
The infant was treated conservatively at home. Treatment consisted of aluminum acetate (Burow) solution compresses 3 times each day, followed by a loose dressing. The lesions crusted in 1 week and completely resolved in 2 weeks. Follow-up, consisting of 13 years of observation, demonstrated no evidence of sequelae, such as postherpetic neuralgia, or recurrence.
Conclusion:
Herpes zoster is uncommon in infants; however, it may occur. The presentation of the rash is characteristic; but otherwise, the condition differs from that in adults in that it is mild and not associated with postherpetic neuralgia. In uncomplicated cases, conservative treatment measures support the quick resolution with no sequelae.
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