Evaluation of paediatric herpes zoster cases: Comparison of herpes zoster attacks in children with and without underlying conditions

Abstract

Aim: Herpes zoster is rarely seen in children, but is more common and more severe in those with underlying medical conditions. The purpose of this study was to comprehensively evaluate cases of herpes zoster in all paediatric patients and to detail the clinical course and complications of this disease in children with and without underlying health problems in terms of similarities and differences.

Methods: The course of paediatric patients diagnosed with herpes zoster in a tertiary university hospital over a 19-year period was evaluated from the time of diagnosis, divided into groups with and without underlying disease.

Results: In our study, where we evaluated 150 herpes zoster attacks in 143 children, 79.3% of the patients (n = 119) had underlying diseases, while 20.7% (n = 31) were healthy children. The age at the time of primary varicella-zoster virus and herpes zoster was significantly younger in the group without an underlying disease compared to the group with an underlying disease. Pain was reported more in the healthy group, and the duration of symptoms was longer. Ophthalmic nerve involvement was significantly higher in the group without a known disease. Treatment was administered in 90% of all attacks. In the group with underlying diseases, the duration of intravenous treatment and hospital stay were significantly higher as expected.

Conclusions: This study shows that herpes zoster attacks in healthy children can also progress with severe symptoms and complications. Approaches to reduce the burden of herpes zoster should be adopted and developed for all paediatric patients.

Keywords: healthy children; herpes zoster; underlying disease.

Fig. 1

Clinical features of herpes zoster cases during hospitalisation. (), Children with comorbidities (n = 119); (), healthy children (n = 31); (), all (n = 150).