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Ann Child Neurol > Volume 25(4); 2017 > Article
Journal of the Korean Child Neurology Society 2017;25(4):281-285.
DOI: https://doi.org/10.26815/jkcns.2017.25.4.281    Published online December 30, 2017.
Herpes Zoster with Aseptic Meningitis in Immunocompetent Children: A Case Series.
Hyun Ji Jang, Hye Won Yoo, Lira Yoon, Ju Hyun Kong, Yunjin Lee, Sang Ook Nam, Young Mi Kim
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.
Key Words: Herpes zoster, Varicella zoster virus, Chickenpox, Aseptic meningitis
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