Clinical Manifestations of Hospitalized Children Due to Varicella-Zoster Virus Infection

Abstract

Purpose: This study was performed to describe the clinical manifestations of hospitalized children due to varicella-zoster virus (VZV) infection Methods: This study included 40 children who were hospitalized for varicella or herpes zoster at Seoul National University Children’s Hospital, 2009-2012. Diagnosis of VZV infection was confirmed by VZV PCR or culture from vesicular fluid. Medicalrecords were reviewed to collect clinical features and outcome, antiviral treatment, history of varicella vaccination, and underlying diseases.Results: Sixteen patients with varicella and 24 patients with herpes zoster were included. Their median age was 10.5 years (16 days-19 years). Thirty-five (87.5%) patients had underlying diseases. Among 24 patients with herpes zoster, 11 patientshad previous history of varicella and 1 had herpes zoster. Twenty patients (50%) had a history of varicella vaccination, and 19 immunocompromised patients had VZV infection despite of vaccination. Most (95%) patients were treated by intra-venous or oral acyclovir, and no treatment failure of intravenous acyclovir was found. The median duration of fever was 4.4 days (1-10 days), and that of antiviral treatment was 12 days (7-23 days) in immunocompromised patients. Immuno-compromised patients received longer duration of antiviral treatment than imunocompetent patients (P=0.014). Eleven (27.5%) immunocompromised patients had postherpetic neuralgia, 2 (5%) had proven co-infection by Streptococcus pyogenesand Klebsiella oxytoca, and 1 (2.5%) complicated with pneumonia. Conclusion: Immunocompromised children require longer duration of treatment and are at risk of severe complication asso-ciated with VZV infection. Early initiation of antiviral therapy and close monitoring are necessary for those in immunocpom-promised conditions. (Korean J Pediatr Infect Dis 2013;20:161-167)KeyWords: Varicella-zoster virus, hospitalized, immunocompromised, children