Ophthalmic herpes zoster in an 11-month-old Cameroonian infant: case report from the Yaoundé Teaching Hospital

Abstract

Ophthalmic zoster, a reactivation of the varicella-zoster virus (VZV), is a very rare condition in infants, with an incidence of approximately 2 per 100,000 per year. Its rarity can be explained by the long delay that usually occurs between primary infection (chickenpox) and reactivation. We present the case of an 11-month-old immunocompetent girl admitted for a painful vesicular rash on the left side of her face with fever. Contact with chickenpox was reported at 3 months of age, with no rash in the infant. The diagnosis of ophthalmic zoster (involvement of the V1 nerve territory) was clinical, based on the presence of Hutchinson's sign without corneal involvement, and led to standard antiviral treatment with a favorable outcome. Although rare and potentially serious, infantile ophthalmic zoster has a good prognosis when treated early. This case is relevant as it shows reactivation of VZV without a primary eruptive phase (chickenpox).