Herpes zoster in 5-year-old girl with no previous history of chickenpox: Case report

Abstract

Herpes zoster (shingles) is caused by VZV (varicella zoster virus) infection. VZV is an enveloped, double-stranded DNA virus belonging to the Herpesviridae family; its genome encodes approximately 70 proteins. In humans, primary infection with VZV occurs when the virus comes into contact with the mucosa of the respiratory tract or conjunctiva. From these sites, it is distributed throughout the body. After primary infection, the virus migrates along sensory nerve fibers to the satellite cells of dorsal root ganglia where it becomes dormant. Reactivation of VZV that has remained dormant within dorsal root ganglia, often for decades after the patient’s initial exposure to the virus in the form of varicella (chickenpox), results in herpes zoster. This case report describes a herpes zoster infection in an immunocompetent 5-yearold girl, whose hetero-anamnesis from the parents provides information that the girl has not had chickenpox, and that she was not vaccinated against chickenpox, the mother denies that she had chickenpox as a child, and during pregnancy. Case report: A 5-year-old girl with the appearance of a macule, papule, vesicular rash in the area of the chest and back, in the area of the 4th, 5th, and 6th dermatome, in the form of clusters. Before the appearance of a rash accompanied by burning pain. Serological analyses in addition to Herpes Zoster infection with elevated values of ELISA VZV IgM positive + 2.8, ELFA VZV IgG-+1.38 positive. This case of a 5-year-old girl with herpes zoster, without previous evidence of varicella infection or immunodeficiency, presents a unique and interesting clinical scenario. It highlights the complexity of VZV infections and the need for comprehensive clinical and immunological evaluations in pediatric patients with herpes zoster. Future research in the mechanisms of viral latency and reactivation in such atypical cases will be critical to enhance our knowledge and management of VZV infections in children.