ISSN - 0973-0958

Pediatric Oncall Journal View Article

Concomitant presentation of Varicella and Herpes zoster – Is it possible?
Mariana Freitas Miranda, António Pedro Bento Guerra, Teresa Sofia Moreira de Oliveira e Castro, Susana Maria Grilo Gomes Godinho.
Department of Pediatrics, Hospital do Espírito Santo de Évora, E.P.E., Évora, Portugal.
A five-years-old boy was referred to the emergency department due to a 12-hour evolution of skin lesions similar to generalized varicella and concomitant herpes zoster in the C6 dermatome. Without history of prior disease or vaccination against varicella-zoster virus. There was an outbreak of varicella in nursery school. He was treated with oral acyclovir, with complete resolution. To our knowledge, it is the first published case of concomitant varicella and herpes zoster due to wild virus. There are only four similar cases described in the international literature, all related to vaccination against varicella-zoster, which is not present in this case. The mechanism responsible for the simultaneous manifestation of varicella and herpes zoster is not known, however a theory under discussion is that the initial viremia during primary infection may cause immediate viral replication in the sensory ganglia, causing cutaneous manifestations and pain in the surrounding dermatomes.

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