Clinical Manifestations of Hospitalized Children Due to Varicella-Zoster Virus Infection

Byung Ok Kwak; Dong Hyun Kim; Hoan Jong Lee; Eun Hwa Choi

doi:10.14776/kjpid.2013.20.3.161

Journal List > Korean J Pediatr Infect Dis > v.20(3) > 1096040

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Kwak, Kim, Lee, and Choi: Clinical Manifestations of Hospitalized Children Due to Varicella-Zoster Virus Infection

Original Article

Korean Journal of Pediatric Infectious Diseases 2013; 20(3): 161-167.

Published online: 26 December 2013

DOI: https://doi.org/10.14776/kjpid.2013.20.3.161

Clinical Manifestations of Hospitalized Children Due to Varicella-Zoster Virus Infection

Byung Ok Kwak, M.D.^*,^†, Dong Hyun Kim, M.D.^*,^‡, Hoan Jong Lee, M.D., Ph.D.^*,^∫, Eun Hwa Choi, M.D., Ph.D.^*,^∫

^*Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea.

^†Department of Pediatrics, Konkuk University School of Medicine, Seoul, Korea.

^‡Department of Pediatrics, Inha University School of Medicine, Incheon, Korea.

^∫Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.

Corresponding author (eunchoi@snu.ac.kr)

Received 15 February 2013 Revised 11 April 2013 Accepted 16 April 2013

Abstract

Purpose

This study was performed to describe the clinical manifestations of hospitalized children due to varicella-zoster virus (VZV) infection.

Methods

This study included 40 children who were hospitalized for varicella or herpes zoster at Seoul National University Children's Hospital, 2009-2012. Diagnosis of VZV infection was confirmed by VZV PCR or culture from vesicular fluid. Medical records were reviewed to collect clinical features and outcome, antiviral treatment, history of varicella vaccination, and underlying diseases.

Results

Sixteen patients with varicella and 24 patients with herpes zoster were included. Their median age was 10.5 years (16 days-19 years). Thirty-five (87.5%) patients had underlying diseases. Among 24 patients with herpes zoster, 11 patients had previous history of varicella and 1 had herpes zoster. Twenty patients (50%) had a history of varicella vaccination, and 19 immunocompromised patients had VZV infection despite of vaccination. Most (95%) patients were treated by intravenous or oral acyclovir, and no treatment failure of intravenous acyclovir was found. The median duration of fever was 4.4 days (1-10 days), and that of antiviral treatment was 12 days (7-23 days) in immunocompromised patients. Immunocompromised patients received longer duration of antiviral treatment than imunocompetent patients (P=0.014). Eleven (27.5%) immunocompromised patients had postherpetic neuralgia, 2 (5%) had proven co-infection by Streptococcus pyogenes and Klebsiella oxytoca, and 1 (2.5%) complicated with pneumonia.

Conclusion

Immunocompromised children require longer duration of treatment and are at risk of severe complication associated with VZV infection. Early initiation of antiviral therapy and close monitoring are necessary for those in immunocpompromised conditions.

Keywords: Varicella-zoster virus, hospitalized, immunocompromised, children

Figures and Tables

Table 1

Clinical Course of Immunocompromised and Immunocompetent Patients

Abbreviations: VZV, varicella-zoster virus; IV, intravenous; ACV, acyclovir; VACV, valacyclovir; FCV, famciclovir.

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