Dissemined cutaneous herpes zoster in an immunocompetent infant

Abstract

Herpes zoster is the clinical consequence of a late reactivation of the varicella zoster virus. It infects mainly the elderly, pediatric cases are uncommon, usually observed in immunocompromised children. We report an unusual clinical presentation of disseminated cutaneous herpes zoster in immunocompetent infant without history of chickenpox but with positive history of maternal varicella during pregnancy. A 22-month-old male infant was addressed to our department because of a history of crops of vesicular eruption on the thoracic area. This infant did not have a history of postnatal varicella, and his mother had acquired varicella infection during the 8th month of pregnancy. Physical examination showed many crops of vesicular lesions grouped on the left scapular area with some disseminated vesicular lesions present on the trunk and the four extremities. Intravenous acyclovir was administrated with total recovery 10 days later. Disseminated cutaneous varicella zoster virus in infancy is exceptional; few cases were reported in the literature. The dissemination is rare in healthy patients; it is more common in immunocompromised patients and likely to be complicated with visceral or neurologic involvement, but in healthy patients, the course is usually benign and not associated with high morbidity as in our case.