Herpes zoster in the medically healthy child and covert severe child abuse.
Herpes zoster is associated with depressed cell-mediated immunity and occurs rarely in the medically healthy nonimmunocompromised child. We report 4 cases of childhood-onset herpes zoster in the absence of a medical disorder. All 4 patients reported experiencing severe, chronic child abuse when the herpes zoster first appeared. It is possible that the severe chronic psychologic stress resulting from the abuse depressed the patients' cell-mediated immune status and thereby predisposed them to herpes zoster. Our findings suggest that the clinician's suspicion should be heightened for the possibility of covert child abuse and secondary stress when managing an otherwise apparently healthy child with herpes zoster.
Gupta
M A
MA
Department of Psychiatry, University of Western Ontario, London, Canada.
Gupta
A K
AK
D000293:Adolescent; D000328:Adult; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology*; D005260:Female; D006562:Herpes Zoster / Q000276:immunology* / Q000523:psychology*; D006801:Humans; D008297:Male; D013315:Stress, Psychological / Q000276:immunology*