The clinical course of herpes zoster is similar in immunocompetent and immunocompromised paediatric patients.

Abstract

We aimed to compare the clinical manifestation of HZ in immunocompetent and immunocompromised children. Medical charts of all consecutive children hospitalized and/or consulted in the Regional Hospital for Infectious Diseases in Warsaw due to HZ were retrospectively analysed. Age, history of varicella, time interval between varicella and HZ, underlying diseases, immunosuppresive therapy, dermatome involvement and HZ complications were analyzed in both groups. In total 152 children were included in the analysis, 56 (36.84%) of them were hospitalsed, whereas 96 (63.16%) were consulted and discharged home due to good general condition. The median age was 10 years (IQR 5.75-12), there were 73 (48.03%) boys and 79 (51.97%) girls. In 16/152 (10.5%) one or more complications occurred, including: skin bacterial superinfection (16/17, 94.2%), sepsis (1/17, 5.9%), meningitis (1/17, 5.9%). Thoracic dermatomes were the most commonly affected (81/152, 53.29%). Most of the children didn't have any immunodeficiencies 118/152 (77.6%), and 34/152 (22.4%) of them were immunocompromised (and had been treated with intravenous acyclovir). The clinical picture of the disease was similar in both groups (Table 1). However, immunocompromised children more often had sacral dermatomes affected (5/35, 14.3% vs. 1/117, 0.9%, p < 0.001), and less often thoracic dermatomes were involved in this group (12/35, 34.3% vs. 69/117, 59%, p = 0.0102). To conclude, herpes zoster occurs in both immunocompetent and immunocompromised children. Clinical manifestations are similar. Serious complications, although uncommon, affect not only immunocompromised patients but also otherwise healthy children.