Disseminated herpes zoster ophthalmicus in an immunocompetent 8-year old boy

Abstract

Varicella results from a primary infection with the varicella virus while herpes zoster is caused by a reactivation of a latent infection. Dissemination of herpes zoster is uncommon in immunocompetent individuals. Reports of disseminated herpes zoster in children are even less common than in adults. An unusual case of disseminated herpes zoster ophthalmicus in an 8-year old immunocompetent black boy is presented. He had a previous primary Varicella zoster virus infection at three years of age. In the current report, he presented during an on-going chicken pox outbreak and survived with no significant complications. A breakthrough varicella virus re-infection or a reactivation is possible, both of which could present as zoster. This case emphasizes the need for prevention of varicella virus infection through universal childhood immunization and effective infection control strategies in health care settings.

Keywords: child; disseminated; herpes zoster; immunocompetent.

Figure 1.

At presentation, pustulo-bullous lesions on the right periorbital and frontal areas with facial edema and subcutaneous emphysema.

Figure 2.

Umbilicated vesicular lesions on the trunk.

Figure 3.

One week after treatment.

Figure 4.

A) Residual ptosis of the right lid and scarring on the frontal region at follow up after six weeks; B) Eye examination revealed no significant corneal or intraocular residual manifestations.