Herpes zoster in infancy

Area of Science:

• Pediatric Infectious Diseases
• Dermatology
• Virology

Background:

• Herpes zoster (HZ) in infancy is exceptionally rare, requiring either primary varicella-zoster virus (VZV) infection or VZV reactivation within the first year of life.
• Neonatal varicella, a precursor to potential VZV reactivation, presents unique challenges in early diagnosis and management.

Purpose of the Study:

• To report a rare case of herpes zoster (HZ) in an immunocompetent infant with a history of neonatal varicella.
• To discuss the clinical presentation, management, and potential complications of infantile HZ.
• To review relevant literature on VZV infections in infancy.

Main Methods:

• Case report of an immunocompetent infant presenting with symptoms suggestive of HZ.
• Review of the infant's medical history, including prior neonatal varicella.
• Literature search for similar cases and established guidelines for infantile HZ management.

Main Results:

• The infant, despite being immunocompetent, developed HZ with characteristic dermatomal lesions.
• The case underscores the possibility of VZV reactivation or primary infection presenting as HZ in early infancy.
• Timely intervention and long-term follow-up are crucial for managing infantile HZ.

Conclusions:

• A high index of clinical suspicion is essential for diagnosing infantile HZ, particularly in infants with crusted lesions in limited dermatomes.
• Early recognition and intervention, alongside prolonged follow-up, can improve clinical outcomes for infants with HZ.
• This case contributes to understanding the spectrum of VZV disease in early life.