Posters

Herpes zoster ophtalmicus (HZO) in childhood: case report

Poster Details

First Author: M.Chafik MOROCCO

Co Author(s): Z. Hammoumi   M. Yassine   R. Nasrouni   L. El Maaloum   B. Allali   A. El Kettani     

Abstract Details

Purpose:

The purpose of this work is to report a case of a six year old child,  with a history of maternal varicella during gestation, who presented a herpes zoster ophthalmic concomitant with a first episode of varicella. Thus, it would demonstrate that the HZO is no longer a disease limited to the elderly and that we should think about it even in children. It would also emphasize the value of early antiviral treatment to limit ocular complications.

Setting:

Pediatric ophthalmological department, 20 August 1953 Hospital, Casablanca, Morocco.

Methods:

Our patient was initially treated for 7 days by another structure as a simple varicella, with a clinical deterioration. Upon our  examination we had found a thick layer of necrotizing crusts covering the left forehead and upper eyelid, with a bilateral eyelid edema particularly on the left. His visual acuity was 8/10 on the left eye, with a pseudo dendritic epithelial keratitis and a diffuse superficial punctuate keratitis in the same eye. Due to the severity of the skin lesions and the delay in management of our patient we recommended an antiviral treatment by acyclovir intravenously, with other symptomatic treatments.

Results:

The evolution was favourable with an improvement in eye and skin damage. No ocular complications were observed. An immune biological analysis was performed to look for a possible immune deficiency, with negative results.

Conclusions:

HZO is a reactivation of varicella-zoster virus involving the ophthalmic branch of the trigeminal nerve (V1), that may cause ocular complications which could lead to vision loss. It is usually a disease of the elderly and the immunocompromised, but is currently seen in younger population and in immunocompetent patient. Oral antiviral treatment is effective and sufficient if given within the first 72 hours. The intravenous pathway is reserved for severe forms especially for the pediatric population.

Financial Disclosure:

None