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   Introduction
   Case Report
   Discussion
   References
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CASE REPORT
Year : 1999  |  Volume : 65  |  Issue : 6  |  Page : 294-295

Herpes zoster in a 9 - month - old infant




Correspondence Address:
Annu Jain


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Source of Support: None, Conflict of Interest: None


PMID: 20921693

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How to cite this article:
Jain A, Singal A, Baruah M C. Herpes zoster in a 9 - month - old infant. Indian J Dermatol Venereol Leprol 1999;65:294-5

How to cite this URL:
Jain A, Singal A, Baruah M C. Herpes zoster in a 9 - month - old infant. Indian J Dermatol Venereol Leprol [serial online] 1999 [cited 2019 Oct 14];65:294-5. Available from: http://www.ijdvl.com/text.asp?1999/65/6/294/4846



  Introduction Top


Herpes zoster is the result of reactivation of residual latent infection, usually of sensory neurons, following a primary varicella infection with varicella zoster virus. Zoster occurs sporadically without demographic, seasonal, gender, racial or occupational differences. It can occur at any age but is rare in infancy. We represent a case of herpes zoster in a 9-month-old infant whose mother gave no history of varicella during antenatal or postnatal period.


  Case Report Top


A 9-month-old infant was seen for grouped vesicular lesions on left frontal region of the scalp of seven days duration. Examination revealed multiple vesicular lesions on an erythematous base distributed along the segment supplied by the supraorbital branch of the ophthalmic division of trigeminal nerve. There was tender retroauricular lymphadenopathy. Patient had no other constitutional symptoms. He was not irritable and was feeding normally. One week later the lesions became crusted [Figure - 1] and healed completely within about two weeks of the first visit. Tzanck smear from the lesions showed many multinucleated giant cells with ballooning degeneration, supplementing the clinical diagnosis of herpes zoster.

There was no history of varicella or herpes zoster in the infant's mother or any other family member during antenatal or postnatal period. However on detailed interrogation, patient's mother could recall a case of varicella in immediate neighbourhood during her second trimester of gestation.


  Discussion Top


Zoster occurs at an overall rate of 3.40 cases per 1000 persons. The lowest incidence is in individuals less than 10 years old (0.74/1000).[1] The earliest age reported is in a 3-month old infant.[2]

In infancy or childhood the disease generally results from reactivation of varicella zoster virus infection acquired either in utero or in early infancy while protected by maternal antibodies.[3],[4],[5]

Only a few cases of herpes zoster in infants have been reported in India,[2], [6], [7] all of which have a documentation of maternal varicella during gestation suggesting that the initial exposure was in utero. In this case we presume that the exposure occurred in utero probably following a subclinical varicella infection in the mother.



 
  References Top

1.Hope Simpson RE. The nature of herpes zoster: a long term study and a new hypothesis. Proc Roy Soc Med 1965;58:9-20.  Back to cited text no. 1    
2.Handa S. Herpes zoster in a 3-month-old infant. Paed Dermatol 1997;14:133.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]
3.Helander I, Arstila P, Terho P. Herpes zoster in a 6-month-old infant. Acta Derm Venereol 1983;63:180-181.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]
4.Laude TA, Rajkumar S. Herpes zoster in a 4-month-old infant. Arch Dermatol 1980;116:160.  Back to cited text no. 4  [PUBMED]  [FULLTEXT]
5.Leukonia IK, Jackson AA. Infantile herpes zoster after intrauterine exposure to varicella. Br Med J 1973;iii:149.  Back to cited text no. 5    
6.Bharija SC, Kanwar AJ, Singh G. Ophthalmic zoster in infancy. Indian J Dermatol 1983;28:153-155.  Back to cited text no. 6    
7.Panda S, Nabachandra TH, Sarkar S, et al. Herpes zoster in an HIV-positive 14-month-old baby. Natl Med J India 1994;7:63-64.  Back to cited text no. 7    


    Figures

[Figure - 1]



 

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