Herpes Zoster Before the First Birthday: A Case Report and Primary Care Perspective
Rui Guilherme Costa1, Mariana Bernardo2
1USF Manuel Cunha, Family Health Unit, Coimbra Local Health Unit, Coimbra, PRT.
Insights
This case report details a rare instance of infant herpes zoster (HZ), or shingles, in a six-month-old. The infant experienced a mild, localized rash and recovered fully within 10 days with conservative management.
Area of Science:
- Pediatrics
- Infectious Diseases
- Dermatology
Background:
- Herpes zoster (HZ), commonly known as shingles, is caused by the reactivation of the varicella-zoster virus.
- While typically seen in older adults, HZ can occur in infants, often presenting atypically.
- Early recognition and management are crucial to prevent potential complications.
Observation:
- A six-month-old male infant presented with a unilateral, dermatomal vesicular rash on the right upper limb and dorsum.
- The infant had a history of varicella (chickenpox) at 48 days of age.
- The infant was afebrile, asymptomatic, and in good general condition during the observation.
Findings:
- Clinical presentation and history strongly suggested a diagnosis of herpes zoster.
- The rash followed a distinct C7-C8 dermatomal distribution.
- Complete resolution of the rash occurred within 10 days.
Implications:
- This case highlights the importance of considering HZ in infants presenting with unusual rashes.
- Routine health surveillance can facilitate early detection of uncommon pediatric conditions.
- A conservative management approach was effective for this mild presentation of infant HZ, emphasizing the role of primary care physicians in managing rare pediatric cases.
Abstract:
This case illustrates a rare presentation of herpes zoster (HZ) in infancy. A six-month-old male infant was observed during a routine health surveillance visit with a four-day history of vesicular rash localized to the right upper limb and dorsum, following a dermatomal distribution (C7-C8). The child had previously had varicella at 48 days of age. He was afebrile, asymptomatic, and in good general condition. Clinical findings and medical history supported a diagnosis of HZ. Given the mild presentation and the time elapsed since onset, a conservative management approach with clinical monitoring was adopted. Complete resolution occurred within 10 days. This case provides an example of HZ in early infancy, identified during routine follow-up, and managed successfully without complications. This case reinforces the importance of clinical suspicion in atypical age groups and highlights the central role of the family physician in longitudinal care and early recognition of uncommon pediatric conditions.
More Related Videos
Related Concept Videos
01:30Tonsillitis I: Introduction
Etiology
Three primary contributing factors have been identified.
01:30Acute Pharyngitis
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
01:30Primary Healthcare Services
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
01:22Development of Immunocompetence
The initial cells that migrate from the fetal thymus settle within the skin and epithelial tissues lining the mouth, digestive tract, and in females, the uterus and vagina. These cells, including skin-based dendritic cells, serve as antigen-presenting cells, playing a key role in T cell activation.
Subsequent T...
01:26Tonsillitis II: Management
01:15Upper Respiratory Drugs: First and Second-Generation Antihistamines
Histamine binds to specific receptor sites, known as H1 receptors, on tissue cells, triggering inflammation and swelling. Antihistamines combat these effects by competing with histamine for these receptor sites. By...