Çocukluk Çağında Herpes Zoster Enfeksiyonu:21 Olgunun Prospektif Değerlendirilmesi

Abstract

Amaç:Herpes zoster(HZ), dorsal kök ganglionunda latent olarak kalan Varicella zoster virüs’ün reaktivasyonu sonucunda gelişen bir hastalıktır. HZ çocukluk çağında nadir görülen bir hastalıktır. HZ, çocukluk çağında immünsupresif ilaç kullanımı, immünyetmezlik ve  malignite durumlarında daha sık olarak karşımıza çıkabilir. Bu çalışmada polikliniğimize başvuran HZ tanısı konulan çocuk hastaların klinik özellikleri ve eşlik eden hastalıklar incelendi.

Materyal ve Metot: Hastanemiz deri ve zührevi hastalıkları polikliniğine Ocak 2017- Temmuz 2018  tarihleri arasında  başvuran  ve HZ  tanısı konulan  18 yaşından küçük 21 hasta prospektif olarak değerlendirildi. Hastalar yaş, cinsiyet, tutulan dermatom, geçirilmiş varisella öyküsü, varicella aşısı öyküsü,  eşlik eden hastalıklar, komplikasyon gelişimi ve tedavi açısından değerlendirildi.

Bulgular: HZ tanısı konulan 21 çocuk hastanın 12(%57,1)’si erkek, 9 (%42,9)’ u kız idi.  Hastaların yaş ortalaması 10,1 yıl (6-16 yaş) olarak saptandı. On dört  (%66,6) hastada torakal dermatom tutulurken, 5 (%23,8) hastada servikal ve 2 (%9,5) hastada lomber dermatom tutulumu izlendi. İki hasta ALL tanısı nedeniyle sistemik kemoterapi almaktaydı.  Hastaların hiçbirinde  varisella aşısı olma öyküsü yoktu. Varisella geçirme öyküsü hastaların 15(%71,4)’inde  vardı. On altı (%76,1) hastaya sistemik antiviral tedavi verildi. Hastalarımızın hiçbirinde disseminasyon gelişmedi. Hastalarda postherpetik nevralji veya majör bir komplikasyon görülmedi. 

Sonuç: HZ,  immünsupresyonu olan çocuk hastalarda sıklıkla görülmesine rağmen sağlıklı çocuklarda da görülebilmektedir. Erişkin hastalara benzer şekilde en sık torakal dermatom  tutulumu görülür. Sağlıklı çocuklarda HZ’ ye  bağlı postherpetik nevralji gibi komplikasyonlar  nadir olarak görülür. 

Keywords

• Çocukluk çağı,herpes zoster,varisella zoster virüs

Herpes Zoster Infection In Childhood: Prospective Evaluation of 21 Cases

Abstract

Background: Herpes zoster (HZ) is a disease caused by the reactivation of varicella zoster virus, which remains latent in the dorsal root ganglion. HZ is a rarely seen disease in childhood. HZ is more common in pediatric patients with immunosuppressive drug use, immunodeficiency and malignancy. This study examined the clinical characteristics of children with HZ.

Methods: Twenty one pediatric patients admitted to our dermatology clinic between January 2017 and July 2018 and diagnosed with HZ were evaluated prospectively. Patients were evaluated in term of age, sex, affected dermatome, history of previous varicella, varicella vaccine, accompanying disease, complication development and treatment.

Results: Twelve (57.1%) of the 21 pediatric patients with HZ were male and 9 (42.9%) were female. The mean age of the patients was 10.1 years (6-16 years).  Fourteen (66.6%) patients had thoracic dermatome involvement, 5 (23.8%) patients had cervical involvement, and 2 (9.5%) patients had lumbar dermatome involvement.  Two patients were receiving systemic chemotherapy for ALL. In our study 71.4% of patients had a history of varicella and there was no history of varicella vaccine in any of the patients. None of the patients developed dissemination and no major complication was observed.

Conclusion: In conclusion, while HZ is also seen in healthy children, children who are immunosuppressed are more affected.  Similar to adult disease, thoracic dermatomal involvement is the most common. Complications such as postherpetic neuralgia due to HZ in healthy children are rarely seen.

Keywords

• Childhood,Herpes Zoster,Varicella zoster virus

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