Herpes zoster in an immunocompetent adolescent - A case of rare occurrence

Abstract

Herpes zoster is an acute viral infection caused by the reactivation of the varicella zoster virus. It occurs commonly in immunocompromised adults. Odontalgia may be an early prodromal symptom when herpes zoster involves the oral and maxillofacial region, which lays significant emphasis on the role of a dentist in early diagnosis and treatment of the infection. Herpes zoster infection commonly affects adult and elderly patients and is very rare in children. This article shows cases of herpes zoster infection in a 14-year-old immunocompetent boy who presented with dental pain as a prodromal sign. Herpes zoster may occur in children and thus should be considered in the differential diagnosis of acute multiple ulcers occurring in that population.

Keywords: Adolescent; herpes zoster; immunocompromised; odontalgia; shingles; trigeminal nerve.

Figure 1

a. Crops of vesicles on left infraorbital region, ala of nose, upper lip and skin near left commissure restricted to the left side [Note: Parental consent obtained for using Photographs]. b. Intraoral picture showing intact vesicles in an erythematous base in the posterior palate, medial to left maxillary tuberosity, anterior palate with inflamed maxillary anterior gingiva. c. Multiple ulcers of size less than 5 mm are seen in the left retromolar region and buccal mucosa

Figure 2

a. Crusting of the vesicles and scar formation on the left side of the face. b. Erosive areas in the left buccal mucosa. c. Ruptured vesicles with ulcerations in the posterior palate and erosive areas in the entire left side of the palate

Figure 3

Complete resolution of vesicular lesion. a) extra oral sites near left infraorbital margin, ala of nose,upper lip and skin near commissure b)left buccal mucosa c) left side of palate