Herpes zoster in immunocompetent and immunocompromised Japanese children

Background: To confirm epidemiological features of herpes zoster among chil dren with or without immunosuppression, herpes zoster patients who had pres ented to this hospital were retrospectively investigated. Methods: Medical records were reviewed for the 92 cases of pediatric herpes zoster patients diagnosed during the period from 1981 to 1998. The age at onset of herpes zoster and of varicella, the interval between varicella and zoster, the dermatomal distribution of herpes zoster and complications wer e compared between immunocompetent and immunocompromised children. Results: The mean age at onset of zoster in immunocompetent children was 8. 5+/-4.0 years and in immunosuppressed children was 9.7+/-3.8 years. The age at onset of varicella was significantly lower (1.6+/-1.8 years) in immunoc ompetent than in immunosuppressed children (4.6+/-2.7 years). The interval between varicella and zoster was 6.2+/-3.2 years in immunocompetent childre n. More than 80% of patients with acute leukemia or malignant lymphoma had herpes zoster within 2 years after diagnosis of malignancy. Lesions of herp es zoster were most frequently found in the thoracic nerve regions. Five of 11 zoster patients with cutaneous dissemination, three of five zoster pati ents having aseptic meningitis and three of four patients complicated facia l palsy were children without underlying disease. Conclusions: The present study confirmed that varicella in the first year o f life was a risk factor in immnocompetent children, as reported previously . Herpes zoster in children without immunosuppression was found not to be a s mild as generally accepted.