Herpes zoster oticus among pediatric patients: Our experiences at a tertiary care teaching hospital

Abstract

Introduction: Herpes zoster oticus (HZO) occurs due to the reactivation of the varicella zoster virus (VZV) in the geniculate ganglion of the facial nerve. It is characterized by erythematous vesicular eruptions on the pinna and external auditory canal with severe otalgia. When it is associated with ipsilateral facial nerve paralysis, a diagnosis of Ramsay Hunt syndrome (RHS) can be made. It is rare in the pediatric age group but with low immunity, so prone for increased risk of disseminated infections, neurological complications, and recurrence of infections. Objective: The aim of this study was to evaluate the clinical profile and management of the HZO among pediatric patients at a tertiary care teaching hospital. Materials and Methods: In this prospective study, 24 pediatric patients of HZO were reviewed those presented during the period of December 2015–January 2020. All pediatric patients underwent thorough clinical examinations before getting the diagnosis. All the participants also underwent thorough neuro-otological and otolaryngological examinations. Results: Out of 24 pediatric patients, 15 were boys and 9 were girls. All were in the pediatric age group with age ranging from 5 years to 16 years. After the diagnosis of HZO/RHS, all were treated with acyclovir for 10 days along with tapering dose of deflazacort, labyrinthine sedatives, and eye care in case of facial palsy. All the pediatric patients were recovered by our treatment protocol except 3 cases those are still in follow-up with facial weakness. Conclusions: Adequate awareness for the HZO in pediatric patients is required, and the management of RHS patients is paramount among pediatrician or pediatric otorhinolaryngologists.

Keywords

• facial nerve palsy
• herpes zoster oticus
• pediatric patients
• ramsay hunt syndrome