Çocukluk Çağında Herpes Zoster Enfeksiyonu:21 Olgunun Prospektif Değerlendirilmesi

Yıl 2019, Cilt: 16 Sayı: 1, 33 - 36, 22.03.2019

Murat Öztürk İsa An Mustafa Aksoy

Öz

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. 

Anahtar Kelimeler

Çocukluk çağı, herpes zoster, varisella zoster virüs

Herpes Zoster Infection In Childhood: Prospective Evaluation of 21 Cases

Öz

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.

Anahtar Kelimeler

Childhood, Herpes Zoster, Varicella zoster virus

Kaynakça

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