Herpes zóster oftálmico en paciente pediátrico sin inmunocompromiso

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Herpes zoster is the reactivation of varicella zoster virus; this disease commonly occurs in patients over 50 years old and immunocompromise is known as the most important risk factor for the onset of this condition. Herpes zoster ophthalmicus is the clinical variant that gives more complications to the patient. Clinical presentation of this disease in children is rare. We aim to present an 8 year old female patient who, came to the emergency room of the Guadalajara's Civilian Hospital with macules and confluent vesicles on right facial region, Hutchinson's sign and no immunocompromise. Herpes zoster ophthalmicus was diagnosed. She was hospitalized for clinical evaluation and to rule out superinfection. This clinical scenario was aggressively treated with topical and systemic acyclovir in order to reduce possible complications. An episode of anterior uveitis appeared one week later and was successfully controlled with topical steroids and cycloplegic. Clinical course evolved without significant sequelae. The patient was kept under observation 3 months after the initial presentation. The diagnosis of this condition is primarily clinical. It is known that one of the most important risk factors in this age group is not immunocompromise but varicella zoster infection during the first year of life. It is paramount to perform an exhaustive evaluation in patients with these criteria to prevent possible long-term sequelae and reduce the risk of amblyopia in case of residual corneal leucomas. The clinical course of herpes zoster ophthalmicus in no-immunodeficient children is generally benign if treated promptly with acyclovir.




Zamora-de La Cruz, D., Saucedo-Rodriguez, L. R., Jauregui-Franco, R. O., Soria-Orozco, C. L., Pérez-Gómez, H. R., & Ascencio-Tene, C. M. (2015). Herpes zóster oftálmico en paciente pediátrico sin inmunocompromiso. Revista Mexicana de Oftalmologia, 89(2), 123–129. https://doi.org/10.1016/j.mexoft.2014.08.006

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