Published: 2017-02-20

Herpes zoster in the radial nerve distribution in an 8 years old healthy child-a case report

Hala Edris, Abdullah Abualiat, Ayed Al Mordy


Varicella zoster is an omnipresent virus which commonly affects childhood as chicken pox. Although the primary infection is self-limiting and seldom severe, the virus remains dormant in the body. The virus resides in the dorsal root or cranial nerve ganglion and reactivation may occur years later as herpes zoster or "Shingles". Herpes zoster (HZ) can occur at any age but is rare in childhood and adolescents. Old aged and immunosuppressed subjects are at risk for developing the disease. The most common area involved in HZ is the trunk (dermatomes innervated by the thoracic nerves) and rarely presents exclusively in the upper extremity. We report a case of HZ isolated to the radial nerve distribution in a healthy 8 years boy. The reported case reveals the importance of considering zoster infection in young age, or uncommon sites when evaluating the onset of pain in a dermatomal distribution specially if associated with vesiculobullous rash.


Herpes zoster, Radial nerve, Shingles

Full Text:



Gnann JW Jr, Whitley RJ. Clinical practice. Herpes zoster. N Engl J Med. 2002;347:340-6.

Yawn BP, Saddier P, Wollan PC, St Sauver JL, Kurland MJ, Sy LS. A population-based study of the incidence and complication rates of herpes zoster before zoster vaccine introduction. Mayo Clin Proc. 2007;82:1341.

Marra F, Lo E, Kalashnikov V, Richardson K. Risk of Herpes Zoster in Individuals on Biologics, Disease-Modifying Antirheumatic Drugs, and/or Corticosteroids for Autoimmune Diseases: A Systematic Review and Meta-Analysis. Open Forum Infect Dis. 2016;3(4):ofw205.

Miller GG, Dummer JS. Herpes simplex and varicella zoster viruses: forgotten but not gone. Am J Transplant. 2007;7:741.

Habel LA, Ray GT, Horberg M, Yawn B, Castillo A, Li Y, et al. The epidemiology of herpes zoster in patients with invasive cancer. J Clin Oncol. 2009;27(15):9562.

Katakam BK, Kiran G, Kumar U A Prospective Study of Herpes Zoster in Children. Indian J Dermatol. 2016;61(5):534-9.

Choi HJ, Kim MY, Kim HO, Park YM. An atypical varicella exanthem associated with the use of infliximab. Int J Dermatol. 2006;45:999.

Carby M, Jones A, Burke M, Hall A, Banner N. Varicella infection after heart and lung transplantation: a single-center experience. J Heart Lung Transplant. 2007;26:399.

Athwal GS, Bartsich SA, Weiland AJ. Herpes zoster in the ulnar nerve distribution. J Hand Surg [Br]. 2005;30(4):355-7.

Chester MH. Segmental reflex sympathetic dystrophy involving the thumb: A rare complication of Varicella zoster infection. Anesthesiology. 1992;77:1223-25.

Johnson RW, Dworkin RH. Treatment of herpes zoster and postherpetic neuralgia. BMJ. 2003;326:748-50.

Aebi C, Ahmed A, Ramilo O. Bacterial complications of primary varicella in children. Clin Infect Dis. 1996;23:698-705.

Bradley JS, Schlievert PM, Sample TG. Streptococcal toxic shock-like syndrome as a complication of varicella. Pediatr Infect Dis J. 1991;10:77-9.