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Complications of herpes zoster in children
Author(s) -
Kanamori Keita,
Shoji Kensuke,
Kinoshita Noriko,
Ishiguro Akira,
Miyairi Isao
Publication year - 2019
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.14025
Subject(s) - medicine , rash , meningitis , complication , postherpetic neuralgia , otitis , pediatrics , pneumonia , keratitis , paralysis , retrospective cohort study , facial paralysis , mastoiditis , medical record , dermatology , surgery , anesthesia , neuropathic pain
Background Herpes zoster (HZ) may cause complications; however, information regarding complications of HZ in children is relatively sparse. We reviewed cases of HZ in children retrospectively and investigated the risk factors contributing to the development of complications. Methods A retrospective observational study was conducted at a tertiary care children’s hospital in Japan. Children receiving a diagnosis of HZ between January 2010 and October 2016 were identified from electronic medical records. In this study, the following diseases were recognized as complications of HZ: bacterial skin infection, facial paralysis, meningitis, uveitis and keratitis, postherpetic neuralgia, acute retinal necrosis, pneumonia, and otitis interna. Details regarding clinical information of HZ patients with complications were described. Results We found 138 cases with HZ. Among these, 58 (42%) occurred in immunocompetent children and 80 cases (58%) occurred in immunocompromised children. Complications were observed in 10 cases of immunocompromised children and in eight cases of immunocompetent children. Although secondary bacterial skin infection was the most common complication ( n = 6, 33.3%), severe complications such as facial paralysis ( n = 3, 16.7%), meningitis ( n = 2, 11.1%), uveitis and keratitis ( n = 2, 11.1%), acute retinal necrosis ( n = 1, 5.6%), pneumonia ( n = 1, 5.6%), and otitis interna ( n = 1, 5.6%) were observed. Patients with complications tended to have a rash on the head or neck, compared with those without complications ( n = 9, 50% vs n = 18, 15%; P = 0.001). Conclusions Severe HZ complications may occur in immunocompetent children. Development of a rash on the head or neck might be a risk factor for complications.