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Herpes Zoster in Children with Underlying Comorbidities: Evaluation of the 10-Year Retrospective Single Center Experience

Yıl 2022, Cilt 12, Sayı 3, 471 - 475, 30.05.2022
https://doi.org/10.16899/jcm.1076070

Öz

Aim: It was aimed to evaluate the complications and prognosis of pediatric patients diagnosed with Herpes zoster(HZ) with an underlying comorbidity. Materials and Methods: Between 01.01.2011-01.01.2021 in our clinic; patients aged 0-18 years, with underlying comorbidities and diagnosed with HZ, who were followed up and treated, were evaluated retrospectively. Sociodemographic characteristics, clinical findings, treatments applied during hospitalization, complications developed during follow-up and prognosis were obtained from hospital file archive records. Results: The mean age was 9.25±4.79 years, and 53.4% of patients were male. The most common symptom was rash, followed by pain and itching. Most commonly, 23 (51.1%) patients had thoracic dermatome involvement. Dissemination did not develop in any of the patients. 8.9% of the patients had chickenpox, 4.4% had varicella vaccine, and 48% had no history of varicella-zoster virus transmission. Acute leukemia and having had a bone marrow transplant were the most common co-existing conditions. Median time between onset of symptoms and diagnosis was 3 (min-max=1-10) days. Median length of hospitalization was 7 (min-max=3-21) days, and the mean total treatment time was 9.33±3.58 days. It was determined that only 4 patients developed secondary skin infection, 44 patients were cured, and 1 patient died due to the primary disease. Conclusion: While HZ is rare in healthy children, it can progress with serious complications in those with an underlying disease. To consider HZ in differential diagnosis of vesicles in immunocompromised patients, to start treatment with early diagnosis; It is of great importance in terms of complications and prognosis that may develop.

Kaynakça

  • 1. Karagün E. Çocukluk Çağı Herpes Zoster Enfeksiyonu: Retrospektif Çalışma. Turk Dermatoloji Dergisi 2019; 13(1): 20.
  • 2. Albrecht MA, Levin MJ, Hirsch M, Mitty J. Epidemiology, clinical manifestations, and diagnosis of herpes zoster. UpToDate Waltham, MA: UpToDate 2020.
  • 3. Wen S-Y, Liu W-L. Epidemiology of pediatric herpes zoster after varicella infection: a population-based study. Pediatrics 2015; 135(3): e565-e71.
  • 4. Lin H-C, Chao Y-H, Wu K-H, et al. Increased risk of herpes zoster in children with cancer: A nationwide population-based cohort study. Medicine 2016; 95(30).
  • 5. Novelli VM, Brunell PA, Geiser CF, Narkewicz S, Frierson L. Herpes zoster in children with acute lymphocytic leukemia. American Journal of Diseases of Children 1988; 142(1): 71-2.
  • 6. Guess HA, Broughton D, Melton L, Kurland L. Epidemiology of herpes zoster in children and adolescents: a population-based study. Pediatrics 1985; 76(4): 512-7.
  • 7. Grote V, von Kries R, Rosenfeld E, Belohradsky BH, Liese J. Immunocompetent children account for the majority of complications in childhood herpes zoster. The Journal of infectious diseases 2007; 196(10): 1455-8.
  • 8. Kanamori K, Shoji K, Kinoshita N, Ishiguro A, Miyairi I. Complications of herpes zoster in children. Pediatrics International 2019; 61(12): 1216-20.
  • 9. ALKAN ÇEVİKER S, GÜNAL Ö, KILIÇ S, Köksal E, Aygün C. İmmunkompetan Yaşlı Hastada Gelişen Herpes Zoster Oftalmikus: Olgu Sunumu. 2019.
  • 10. Shingles Surveillance. http://www.cdc.gov/shingles/surveillance.html (accessed 01 July 2021.
  • 11. Katakam BK, Kiran G, Kumar U. A prospective study of herpes zoster in children. Indian journal of dermatology 2016; 61(5): 534.
  • 12. Tepe B, Bucak ÝH, Almýþ H. Saglikli Çocuklarda Herpes Zoster: Retrospektif Bir Çalisma/Herpes Zoster in Healthy Children: A Retrospective Study. Turk Dermatoloji Dergisi 2016; 10(2): 65.
  • 13. Çiftdoğan DY. The Time of the Primary Varicella Zoster Virus Infection in Previously Healthy Children with Herpes Zoster: Is It Important? Cocuk Enfeksiyon Dergisi 2017; 11(2): E60-E4.
  • 14. Kuchar E, Szenborn L, Lis I, Jaroszewska A, Czeladzka J. Clinical presentation of herpes zoster in immunocompetent and immunocompromised hospitalized children treated with acyclovir. Journal of pediatric hematology/oncology 2016; 38(5): 394-7.
  • 15. Takayama N, Yamada H, Kaku H. Herpes zoster in immunocompetent and immunocompromised Japanese children. Pediatrics International 2000; 42(3): 275-9.
  • 16. Nair PA, Patel PH. Herpes zoster in children and adolescents: case series of 8 patients. National J Comm Med 2013; 4: 182-4.
  • 17. Donahue JG, Choo PW, Manson JE, Platt R. The incidence of herpes zoster. Archives of internal medicine 1995; 155(15): 1605-9.
  • 18. LATIF R, SHOPE TC. Herpes zoster in normal and immunocompromised children. American Journal of Diseases of Children 1983; 137(8): 801-2.
  • 19. Pétursson G, Helgason S, Gudmundsson S, Sigurdsson JA. Herpes zoster in children and adolescents. The Pediatric infectious disease journal 1998; 17(10): 905-8.
  • 20. Pergam S, Forsberg C, Boeckh M, et al. Herpes zoster incidence in a multicenter cohort of solid organ transplant recipients. Transplant Infectious Disease 2011; 13(1): 15-23.
  • 21. Hata A, Kuniyoshi M, Ohkusa Y. Risk of Herpes zoster in patients with underlying diseases: a retrospective hospital-based cohort study. Infection 2011; 39(6): 537-44.
  • 22. Wootton SH, Law B, Tan B, et al. The epidemiology of children hospitalized with herpes zoster in Canada: Immunization Monitoring Program, Active (IMPACT), 1991–2005. The Pediatric infectious disease journal 2008; 27(2): 112-8.
  • 23. Gnann Jr JW, Whitley RJ. Clinical practice. Herpes zoster. The New England journal of medicine 2002; 347(5): 340-6.
  • 24. Dworkin RH, Johnson RW, Breuer J, et al. Recommendations for the management of herpes zoster. Clinical infectious diseases 2007; 44(Supplement_1): S1-S26.
  • 25. Kurlan JG, Connelly BL, Lucky AW. Herpes zoster in the first year of life following postnatal exposure to varicella-zoster virus: four case reports and a review of infantile herpes zoster. Archives of dermatology 2004; 140(10): 1268-72.
  • 26. Baba K, Yabuuchi H, Takahashi M, Ogra PL. Increased incidence of herpes zoster in normal children infected with varicella zoster virus during infancy: community-based follow-up study. The Journal of pediatrics 1986; 108(3): 372-7.
  • 27. Civen R, Chaves SS, Jumaan A, et al. The incidence and clinical characteristics of herpes zoster among children and adolescents after implementation of varicella vaccination. The Pediatric infectious disease journal 2009; 28(11): 954-9.
  • 28. Civen R, Marin M, Zhang J, et al. Update on incidence of herpes zoster among children and adolescents after implementation of varicella vaccination, Antelope Valley, CA, 2000 to 2010. The Pediatric infectious disease journal 2016; 35(10): 1132-6.

Altta yatan Komorbiditeleri Olan Çocuklarda Herpes Zoster: 10 Yıllık Retrospektif Tek Merkez Deneyiminin Değerlendirilmesi

Yıl 2022, Cilt 12, Sayı 3, 471 - 475, 30.05.2022
https://doi.org/10.16899/jcm.1076070

Öz

Amaç: Altta yatan ek hastalığı olan Herpes zoster (HZ) tanısı almış çocuk hastaların komplikasyonlarının ve prognozlarının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Kliniğimizde 01.01.2011-01.01.2021 tarihleri arasında 0-18 yaş arası altta yatan ek hastalığı bulunan ve HZ tanısı konularak takip ve tedavi edilmiş hastalar retrospektif olarak değerlendirildi. Sosyodemografik özellikleri, klinik bulguları, hastane yatışları süresince uygulanan tedaviler ve takipte gelişen komplikasyonları ve prognozları dosya kayıtlarından elde edildi. Bulgular: Ortalama yaş 9,25±4,79 yıl olup hastaların %53.4’ü erkek idi. En yaygın semptom döküntü iken bunu ağrı ve kaşıntı izlemekteydi. En sık olarak 23 (%51.1) hasta ile torakal dermatom tutulumu mevcuttu. Dört (%8.8) hastada birden fazla dermatom tutulumu vardı. Hastaların hiçbirinde disseminasyon gelişmedi. Hastaların %8,9’u suçiçeği geçirmiş, %4,4’ü suçiçeği aşısı olmuş, %48’inin varisella-zoster virus geçirme öyküsü bilinmiyordu. Akut lösemi ve kemik iliği nakli olmuş olma en sık altta yatan ek durumlardandı. Semptomların başlama ve tanı koyma arasındaki ortanca süre 3 (min-max=1-10) gündü. Hastaların tümüne asiklovir tedavisi başlandı. Yatış ortanca süresi 7 (min-max=3-21) gün, toplam tedavi süresi ortalama 9,33±3,58 gündü. Sadece 4 hastada sekonder cilt enfeksiyonu geliştiği, 44 hastanın şifa ile iyileştiği ve 1 hastanın primer hastalığı nedeniyle exitus olduğu saptandı. Sonuç: HZ sağlıklı çocuklarda nadir iken alta yatan hastalığı olanlarda ciddi komplikasyonlarla seyredebilir. İmmunkompromise hastalarda veziküllerin ayırıcı tanısında HZ’i düşünmek, erken tanı konularak tedavi başlamak; gelişebilecek komplikasyonlar ve prognoz açısından büyük öneme sahiptir.

Kaynakça

  • 1. Karagün E. Çocukluk Çağı Herpes Zoster Enfeksiyonu: Retrospektif Çalışma. Turk Dermatoloji Dergisi 2019; 13(1): 20.
  • 2. Albrecht MA, Levin MJ, Hirsch M, Mitty J. Epidemiology, clinical manifestations, and diagnosis of herpes zoster. UpToDate Waltham, MA: UpToDate 2020.
  • 3. Wen S-Y, Liu W-L. Epidemiology of pediatric herpes zoster after varicella infection: a population-based study. Pediatrics 2015; 135(3): e565-e71.
  • 4. Lin H-C, Chao Y-H, Wu K-H, et al. Increased risk of herpes zoster in children with cancer: A nationwide population-based cohort study. Medicine 2016; 95(30).
  • 5. Novelli VM, Brunell PA, Geiser CF, Narkewicz S, Frierson L. Herpes zoster in children with acute lymphocytic leukemia. American Journal of Diseases of Children 1988; 142(1): 71-2.
  • 6. Guess HA, Broughton D, Melton L, Kurland L. Epidemiology of herpes zoster in children and adolescents: a population-based study. Pediatrics 1985; 76(4): 512-7.
  • 7. Grote V, von Kries R, Rosenfeld E, Belohradsky BH, Liese J. Immunocompetent children account for the majority of complications in childhood herpes zoster. The Journal of infectious diseases 2007; 196(10): 1455-8.
  • 8. Kanamori K, Shoji K, Kinoshita N, Ishiguro A, Miyairi I. Complications of herpes zoster in children. Pediatrics International 2019; 61(12): 1216-20.
  • 9. ALKAN ÇEVİKER S, GÜNAL Ö, KILIÇ S, Köksal E, Aygün C. İmmunkompetan Yaşlı Hastada Gelişen Herpes Zoster Oftalmikus: Olgu Sunumu. 2019.
  • 10. Shingles Surveillance. http://www.cdc.gov/shingles/surveillance.html (accessed 01 July 2021.
  • 11. Katakam BK, Kiran G, Kumar U. A prospective study of herpes zoster in children. Indian journal of dermatology 2016; 61(5): 534.
  • 12. Tepe B, Bucak ÝH, Almýþ H. Saglikli Çocuklarda Herpes Zoster: Retrospektif Bir Çalisma/Herpes Zoster in Healthy Children: A Retrospective Study. Turk Dermatoloji Dergisi 2016; 10(2): 65.
  • 13. Çiftdoğan DY. The Time of the Primary Varicella Zoster Virus Infection in Previously Healthy Children with Herpes Zoster: Is It Important? Cocuk Enfeksiyon Dergisi 2017; 11(2): E60-E4.
  • 14. Kuchar E, Szenborn L, Lis I, Jaroszewska A, Czeladzka J. Clinical presentation of herpes zoster in immunocompetent and immunocompromised hospitalized children treated with acyclovir. Journal of pediatric hematology/oncology 2016; 38(5): 394-7.
  • 15. Takayama N, Yamada H, Kaku H. Herpes zoster in immunocompetent and immunocompromised Japanese children. Pediatrics International 2000; 42(3): 275-9.
  • 16. Nair PA, Patel PH. Herpes zoster in children and adolescents: case series of 8 patients. National J Comm Med 2013; 4: 182-4.
  • 17. Donahue JG, Choo PW, Manson JE, Platt R. The incidence of herpes zoster. Archives of internal medicine 1995; 155(15): 1605-9.
  • 18. LATIF R, SHOPE TC. Herpes zoster in normal and immunocompromised children. American Journal of Diseases of Children 1983; 137(8): 801-2.
  • 19. Pétursson G, Helgason S, Gudmundsson S, Sigurdsson JA. Herpes zoster in children and adolescents. The Pediatric infectious disease journal 1998; 17(10): 905-8.
  • 20. Pergam S, Forsberg C, Boeckh M, et al. Herpes zoster incidence in a multicenter cohort of solid organ transplant recipients. Transplant Infectious Disease 2011; 13(1): 15-23.
  • 21. Hata A, Kuniyoshi M, Ohkusa Y. Risk of Herpes zoster in patients with underlying diseases: a retrospective hospital-based cohort study. Infection 2011; 39(6): 537-44.
  • 22. Wootton SH, Law B, Tan B, et al. The epidemiology of children hospitalized with herpes zoster in Canada: Immunization Monitoring Program, Active (IMPACT), 1991–2005. The Pediatric infectious disease journal 2008; 27(2): 112-8.
  • 23. Gnann Jr JW, Whitley RJ. Clinical practice. Herpes zoster. The New England journal of medicine 2002; 347(5): 340-6.
  • 24. Dworkin RH, Johnson RW, Breuer J, et al. Recommendations for the management of herpes zoster. Clinical infectious diseases 2007; 44(Supplement_1): S1-S26.
  • 25. Kurlan JG, Connelly BL, Lucky AW. Herpes zoster in the first year of life following postnatal exposure to varicella-zoster virus: four case reports and a review of infantile herpes zoster. Archives of dermatology 2004; 140(10): 1268-72.
  • 26. Baba K, Yabuuchi H, Takahashi M, Ogra PL. Increased incidence of herpes zoster in normal children infected with varicella zoster virus during infancy: community-based follow-up study. The Journal of pediatrics 1986; 108(3): 372-7.
  • 27. Civen R, Chaves SS, Jumaan A, et al. The incidence and clinical characteristics of herpes zoster among children and adolescents after implementation of varicella vaccination. The Pediatric infectious disease journal 2009; 28(11): 954-9.
  • 28. Civen R, Marin M, Zhang J, et al. Update on incidence of herpes zoster among children and adolescents after implementation of varicella vaccination, Antelope Valley, CA, 2000 to 2010. The Pediatric infectious disease journal 2016; 35(10): 1132-6.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Orjinal Araştırma
Yazarlar

Ümmühan ÇAY
ÇUKUROVA ÜNİVERSİTESİ, TIP FAKÜLTESİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, ÇOCUK SAĞLIĞI VE HASTALIKLARI ANABİLİM DALI, ÇOCUK ENFEKSİYON HASTALIKLARI BİLİM DALI
0000-0001-5803-878X
Türkiye


Adnan BARUTÇU (Sorumlu Yazar)
ÇUKUROVA ÜNİVERSİTESİ, TIP FAKÜLTESİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, ÇOCUK SAĞLIĞI VE HASTALIKLARI ANABİLİM DALI, SOSYAL PEDİATRİ BİLİM DALI
0000-0001-8930-1122
Türkiye


Özlem ÖZGÜR GÜNDEŞLİOĞLU
ÇUKUROVA ÜNİVERSİTESİ, TIP FAKÜLTESİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, ÇOCUK SAĞLIĞI VE HASTALIKLARI ANABİLİM DALI, ÇOCUK ENFEKSİYON HASTALIKLARI BİLİM DALI
0000-0003-2202-7645
Türkiye


Derya ALABAZ
ÇUKUROVA ÜNİVERSİTESİ, TIP FAKÜLTESİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, ÇOCUK SAĞLIĞI VE HASTALIKLARI ANABİLİM DALI, ÇOCUK ENFEKSİYON HASTALIKLARI BİLİM DALI
0000-0003-4809-2883
Türkiye

Yayımlanma Tarihi 30 Mayıs 2022
Kabul Tarihi 15 Mart 2022
Yayınlandığı Sayı Yıl 2022, Cilt 12, Sayı 3

Kaynak Göster

AMA Çay Ü. , Barutçu A. , Özgür Gündeşlioğlu Ö. , Alabaz D. Herpes Zoster in Children with Underlying Comorbidities: Evaluation of the 10-Year Retrospective Single Center Experience. J Contemp Med. 2022; 12(3): 471-475.