title: Eczema herpeticum in children: clinical features and factors predictive of hospitalization.
abstract: OBJECTIVE
  To describe the clinical characteristics of pediatric patients with eczema herpeticum and to determine the predictors of hospitalization, and recurrence and repeat episodes.
  
  
  METHODS
  A retrospective cohort study of patients 0-18 years of age diagnosed with eczema herpeticum between May 2000 and April 2009 was carried out at a tertiary pediatric care center in Canada. Seventy-nine patients were included. The primary outcome was hospitalization; secondary outcomes were recurrent and repeat episodes of eczema herpeticum.
  
  
  RESULTS
  At presentation, 76% of 79 patients with eczema herpeticum had a generalized eruption, 56% had fever, 37% had systemic symptoms, and 10% had eye involvement (keratoconjunctivitis). Forty-five patients (57%) were hospitalized. Predictors for hospitalization included male sex (OR = 3.09; 95% CI, 1.20-7.95, P = .017), fever (OR = 5.75; 95% CI, 2.17-15.26, P < .001), systemic symptoms (OR = 2.84; 95% CI, 1.06-7.62, P = .035), and age <1 year (OR = 7.17; 95% CI, 2.17-23.72, P = .001). Recurrence rate (<1 month) was 8.9% and rate of repeat episodes (>1 month) was 16%. Hospitalized patients were more likely to have a repeat episode (OR = 8.25; 95% CI, 0.99-68.69, P = .05). Patients with a previous history of eczema herpeticum had increased likelihood of early recurrence (OR = 6.80; 95% CI, 0.99-46.62, P = .05) and repeat episodes (OR = 9.43; 95% CI, 1.52-55.9, P = .01).
  
  
  CONCLUSIONS
  Predictors of hospitalization in this cohort included male sex, age <1 year, fever, and systemic symptoms at presentation. Hospitalized patients may be at risk for repeat episodes of eczema herpeticum.
authors.affiliation: Division of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Nadia Jennifer Chiara
authors.initials: NJ
authors.lastname: Luca
authors.forename: Irene
authors.initials: I
authors.lastname: Lara-Corrales
authors.forename: Elena
authors.initials: E
authors.lastname: Pope
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use; D000293:Adolescent; D000465:Algorithms; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007617:Kaposi Varicelliform Eruption / Q000175:diagnosis* / Q000188:drug therapy / Q000628:therapy; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir