Herpes zoster in children

Herpes zoster - a peculiar form of the disease caused by the varicella-zoster virus, is accompanied by vesicular eruptions along the course of individual sensitive nerves.

[1], [2], [3],

Causes of the herpes zoster in a child

The disease occurs when the varicella-zoster virus spreads perineurally in individuals with decreased humoral immunity. After the transferred varicella, the virus remains in the intervertebral ganglia for many years as a latent persistent infection. Circulating humoral antibodies, as well as reactions of cellular cytotoxicity, are not capable of completely eliminating intracellularly parasitizing virus. With a sharp weakening of local and general immunity, activation of the virus is possible. Infection manifests itself in the form of a local process associated with the zone of innervation of the affected sensory ganglia. The disease occurs in older children and in adults who have suffered chicken pox in the past. Children under the age of 10 are rarely ill. After contact with patients with herpes zoster, a seronegative child may develop chicken pox.

[4], [5], [6], [7], [8]

Symptoms of the herpes zoster in a child

Herpes zoster begins acutely, with an increase in body temperature, the appearance of burning, itching, tingling and pain along the course of the affected sensory nerves. There may also be general malaise, weakness. Soon along the nerve branches reddening and densification of the skin appear, and then, by the end of the first day (less often on the second day), groups of tightly located red papules with a rapid evolution into bubbles 0.3-0.5 cm in size, filled with transparent contents, are formed. The rash has a tendency to fuse. A few days later the contents of the vesicles grow turbid, and the erythematous background turns pale. By the end of the first - the beginning of the second week of the disease, the bubbles dry up, crusts form, which then disappear, leaving a slight pigmentation. Sometimes the period of rash is prolonged, repeated eruptions of erythematous spots and vesicles are possible. Observe the swelling of the regional lymph nodes.

There are also more severe forms of the disease:

• bullous (large bubbles);
• hemorrhagic (the contents of hemorrhagic bubbles);
• gangrenous (formation of a black scab in the place of the blisters with subsequent ulceration);
• generalized (rashes of individual vesicles in different parts of the body, in addition to typical bubbles along the sensory nerves).

Most often affected areas of skin innervated by intercostal nerves, as well as along the innervation of the trigeminal nerve. Rarely are the extremities affected. The process is almost always one-sided.

Along with difficult options, there are abortive forms. In these cases, typical vesicles are not formed, but there are grouped papules located on erythematous spots.

In children, herpes zoster is rarely accompanied by neuralgia, even more rarely neuralgia persists after the disappearance of the rash, and in adults the neuralgic pains in the affected area are very intense and can last for many months.

[9], [10], [11], [12]

Diagnostics of the herpes zoster in a child

The diagnosis is based on the characteristic grouped vesicles on the erythematous spots along the sensory nerve.

From laboratory methods use the same, as at a chicken smallpox.

[13], [14], [15], [16], [17], [18]

Treatment of the herpes zoster in a child

Assign analgesics, salicylates, ultrasound, ultraviolet radiation, electrophoresis with novocaine, novocaine blockades. In severe cases, intravenous injections of acyclovir and other antiviral drugs are prescribed for 7-10 days, including an interferon-cycloferon inducer at a rate of 10 mg / kg.

The course use of tactotin is shown, the drug is administered subcutaneously on 1 ml daily for 7-10 days. The course of treatment can be repeated after 2-3 weeks.