Herpes zoster in a 6-month-old infant with 13-year follow-up: a retrospective case report

ObjectiveThe purpose of this report is to present a case of herpes zoster in a 6-month-old infant, conservatively managed without oral antivirals, and its 13-year follow-up, demonstrating no sequelae or recurrences.Clinical FeaturesA 6-month-old white female infant presented with a vesicular rash of the right lower extremity to a chiropractic office. The rash consisted of grouped vesicles on erythematous plaques, the characteristic herpetiform lesion, distributed in the S1 dermatome of the right lower extremity only. The infant's history was significant for exposure to chicken pox at age 1 week through siblings. Consequently, only one vesicle developed, representing subclinical chicken pox. The clinical diagnosis of herpes zoster was made.Intervention and OutcomeThe infant was treated conservatively at home. Treatment consisted of aluminum acetate (Burow) solution compresses 3 times each day, followed by a loose dressing. The lesions crusted in 1 week and completely resolved in 2 weeks. Follow-up, consisting of 13 years of observation, demonstrated no evidence of sequelae, such as postherpetic neuralgia, or recurrence.ConclusionHerpes zoster is uncommon in infants; however, it may occur. The presentation of the rash is characteristic; but otherwise, the condition differs from that in adults in that it is mild and not associated with postherpetic neuralgia. In uncomplicated cases, conservative treatment measures support the quick resolution with no sequelae.