Herpes Zoster in Childhood: Three Cases and Review of the Literature

Varicella-zoster virus (VZV) is a member of the alpha-herpesvirus family, causing varicella upon primary infection and remaining latent in the nerve ganglia. Reactivation of the virus leads to herpes zoster. The disease is rare in healthy children and typically presents with mild symptoms. Three cases of herpes zoster in boys aged 9 to 12 years are reported. Two of the children had no history of clinically evident varicella or vaccination, while the third child had a history of varicella at the age of four. In all three cases, the rash was unilateral and involved the T-5 dermatome. Treatment with oral acyclovir and topical agents resulted in complete recovery. Herpes zoster in childhood is more frequently observed after a history of varicella than following vaccination. The incidence of the disease in children under the age of fourteen years old is relatively low. Reactivation of the virus is associated with a temporary decline in cell-mediated immunity. The diagnosis is usually clinical, but it can be confirmed by serological and molecular methods. Treatment involves oral acyclovir, and in immunocompromised children, intravenous administration may be required. Complications are rare, but they may be of neurological, ophthalmological, or otological origin.