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Dermatology
Herpes zoster as the initial manifestation of varicella-zoster virus infection in a healthy toddler
  1. Fatma N Hamed1,
  2. Rhiannon A Bates2 and
  3. Stamatios Oikonomou1
  1. 1Dermatology, Barnsley Hospital NHS Foundation Trust, Barnsley, UK
  2. 2School of Medicine and Population Health, The University of Sheffield Medical School, Sheffield, UK
  1. Correspondence to Dr Fatma N Hamed; fatima.hamed{at}nhs.net

Abstract

Herpes zoster (HZ), commonly known as shingles, is a painful blistering rash in dermatomal distribution, caused by the reactivation of varicella-zoster virus (VZV) that was acquired during a primary varicella infection. While commonly afflicting adults, cases of HZ in paediatric patients are infrequently reported. Such cases are predominantly reported in children who have had prior exposure to VZV, either during pregnancy, early childhood or have been vaccinated with live attenuated VZV. This report presents the first known case to our knowledge of HZ as the initial manifestation of a VZV infection in an immunocompetent toddler in the UK. The report details the chronology of the infection event and discusses the clinical context behind HZ presentations in paediatrics globally. It provides a compelling illustration of the uncommon presentation of VZV infection in an immunocompetent child devoid of antecedent virus exposure, thus meriting acknowledgement and potentially further investigation as to the cause.

  • Dermatology
  • Immunology

https://doi.org/10.1136/bcr-2023-259358

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    Footnotes

    • X @na

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: FNH. The following authors were responsible critical revision for important intellectual content: FNH and RAB. The following authors gave final approval of the manuscript: FNH and SO.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.