title: Herpes zoster stromal keratitis after varicella vaccine booster in a pediatric patient.
abstract: OBJECTIVE
  In this study, the case of a healthy pediatric patient who presented with herpes zoster (HZ) stromal keratitis after vaccination with live attenuated varicella vaccine (Varivax) and subsequent booster is described.
  
  
  METHODS
  This is a retrospective case review.
  
  
  RESULTS
  A 6-year-old girl with no medical history presented with HZ ophthalmicus and stromal keratitis. She had received the original Varivax vaccine at 1 year of age and a booster 1 year before presentation. Topical prednisolone acetate was started with subsequent improvement in inflammation and visual acuity. However, the patient was unable to be completely tapered off the steroids because of reactivation.
  
  
  CONCLUSIONS
  HZ ophthalmicus with stromal keratitis is a rare but potentially damaging manifestation of the varicella zoster virus in the pediatric population. Long-term data regarding reactivation rates in the post-vaccination era are still limited. Close follow-up is needed to ensure resolution of the infiltrates, and reactivation may require long-term steroid therapy.
authors: Department of Ophthalmology, University of Florida, Gainesville, FL.
authors: Peter
authors: P
authors: Krall
authors: Anup
authors: A
authors: Kubal
mesh_terms: D000287:Administration, Topical; D019433:Chickenpox Vaccine / Q000009:adverse effects*; D002648:Child; D003319:Corneal Stroma / Q000187:drug effects / Q000821:virology*; D003320:Corneal Ulcer / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006563:Herpes Zoster Ophthalmicus / Q000188:drug therapy / Q000209:etiology*; D014645:Herpesvirus 3, Human / Q000472:pathogenicity; D006801:Humans; D007117:Immunization, Secondary / Q000009:adverse effects*; D009883:Ophthalmic Solutions; D011239:Prednisolone / Q000031:analogs & derivatives / Q000627:therapeutic use; D014611:Vaccination
chemical_list: D019433:Chickenpox Vaccine; D005938:Glucocorticoids; D009883:Ophthalmic Solutions; C009935:prednisolone acetate; D011239:Prednisolone