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Herpes zoster meningitis in immunocompetent children: Two case reports and a literature review
Author(s) -
Itoh Naohiro,
Motokura Kouji,
Kumakura Akira,
Hata Daisuke,
Hata Atsuko
Publication year - 2017
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.13362
Subject(s) - medicine , meningitis , pediatrics , complication , varicella zoster virus , aciclovir , varicella vaccine , viral meningitis , virus , strain (injury) , herpesviridae , surgery , virology , immunization , viral disease , immunology , bacterial meningitis , antibody
We encountered two cases of Herpes zoster ( HZ ) meningitis, a rarely occurring complication of HZ , in previously healthy children. One patient treated with i.v. acyclovir ( ACV , 31 mg/kg/day) did not recover. His symptoms were relieved somewhat by increased ACV dosage, but it caused transient renal dysfunction. Another patient treated with i.v. ACV (30 mg/kg/day) recovered. Treatment for HZ meningitis in immunocompetent children has not been established. In a literature review, 80% of 20 patients were treated with the usual dose of ACV 15–30 mg/kg/day. The present cases suggest that a high dosage of ACV up to 60 mg/kg/day should be considered (while monitoring for side‐effects) unless symptoms improve. In the review, one of every three vaccine‐strain Varicella zoster virus ( VZV ) cases was severe, whereas the present cases resulted from wild type. Further investigations must examine different clinical characteristics of HZ meningitis caused by wild‐type and vaccine‐strain VZV .