The Skin and the Eye - Herpes Zoster Ophthalmicus in a Healthy 18-month-old Toddler

Abstract

Herpes zoster, caused by reactivation of varicella-zoster virus, is uncommon in infancy. Even more uncommon is herpes zoster ophthalmicus, defined as herpes zoster of the ophthalmic branch of the fifth cranial nerve. Among healthy children, primary varicella-zoster virus infection during gestation as a result of maternal varicella or the first year of life is the major risk factor for development of herpes zoster in a relatively young age. Here we present an unusual case of herpes zoster ophthalmicus with dissemination in an immunocompetent toddler with favorable outcome. The child's mother contracted chickenpox in late pregnancy and her son was very likely infected with varicella-zoster virus in utero. During a two-year follow-up the child vision was normal and there was no evidence of post herpetic neuralgia.

Herpes Zoster Onset 9 Years After First Varicella Zoster Vaccination in an 11-year-old Child - A Case Report

“…In contrary, HZ in children under 10 years of age, that is caused by the wild-type VZV strain, tends to manifest in the thoracic area, a fact which can theoretically be attributed to the central distribution of the rash during varicella infection [4]. When it comes to a comparison between the adult and the pediatric population, cranial involvement or dissemination of HZ tends to be much less frequent in children compared to adults [10]. Furthermore, while in adults a HZ infection has been traditionally regarded as a potential indicator for immunosuppression or underlying tumor, an association with malignancy is only rarely seen in children [10].…”

“…When it comes to a comparison between the adult and the pediatric population, cranial involvement or dissemination of HZ tends to be much less frequent in children compared to adults [10]. Furthermore, while in adults a HZ infection has been traditionally regarded as a potential indicator for immunosuppression or underlying tumor, an association with malignancy is only rarely seen in children [10].…”

Ophthalmic Zoster, A Rare Pathology in a Child

“…The most common ocular disorders are keratitis, iritis and optic neuritis, but all structures of the eye can be affected. Involvement of the nasociliary branch, known as Hutchinson's sign, is considered to be a precursor to skin involvement of the nasal tip [12].…”

Ophthalmic Zoster with Keratitis: A Rare Skin Disease in Children

“…Herpes zosteris a reactivation of the virus varicella zoster and is usually a disease of the elderly. Childhood herpes zoster is believed to be rare, and particularly the ophthalmic form, defined as herpes zoster of the ophthalmic branch of the fifth cranial nerve [1]. This can be responsible for serious eye complications requiring adequate and early management [2].…”