J Korean Child Neurol Soc.  2017 Dec;25(4):281-285. 10.26815/jkcns.2017.25.4.281.

Herpes Zoster with Aseptic Meningitis in Immunocompetent Children: A Case Series

Affiliations
  • 1Department of Pediatrics, Pusan National University Hospital, Pusan National University School of Medicine and Biochemical Research Institute, Busan, Korea. pink2129@naver.com
  • 2Department of Pediatrics, Pusan National University Yangsan Hospital, Pusan National University School of Medicine and Biochemical Research Institute, Yangsan, Korea.

Abstract

Primary clinical features of rash and neurological complications due to varicella zoster virus (VZV) reactivation are rare in a healthy population, especially in immunocompetent children. Early diagnosis and prompt treatment are delayed often due to their rarity. We present four immunocompetent children with VZV reactivation resulting in aseptic meningitis and herpes zoster affecting multiple cranial and spinal nerves. We reviewed the clinical manifestations, laboratory findings, treatment options and outcome of aseptic meningitis associated VZV reactivation. All patients presented with the typical skin lesion of VZV reactivation and definitive laboratory findings of central nervous system infection, without systemic inflammation. Initial manifestations of VZV reactivation included Ramsay Hunt syndrome, herpes zoster ophthalmicus, and herpes zoster affecting the left thoracic dermatomes 4-5. Intravenous acyclovir was administered and all patients recovered fully without any significant sequelae. VZV reactivation can lead to various neurological complications in immunocompetent children. Early recognition and treatment with acyclovir are important for improving the outcome of neurologic complications of VZV reactivation.

Keyword

Herpes zoster; Varicella zoster virus; Chickenpox; Aseptic meningitis

MeSH Terms

Acyclovir
Central Nervous System Infections
Chickenpox
Child*
Early Diagnosis
Exanthema
Herpes Zoster Ophthalmicus
Herpes Zoster Oticus
Herpes Zoster*
Herpesvirus 3, Human
Humans
Inflammation
Meningitis, Aseptic*
Skin
Spinal Nerves
Acyclovir
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