Introduction: studies focusing on the complication rates of varicella-zoster virus (VZV)-associated infections in children with immune deficiencies are scarce. Herein, we sought to analyze our experience.
Methods: a retrospective analysis of the medical records of children with primary or secondary immune deficiencies, who were admitted with a diagnosis of chickenpox or herpes zoster between 2008 and 2016 to the pediatric division in Hadassah-Hebrew University Medical Center. Data regarding presentation, course and mainly about complications and outcome were analyzed.
Results: Seventy four immunocompromised children (43.2% males, mean age 7.53; range: 0.9-19 years) were admitted with VZV-associated infections within the study period. Most children (95.9%) had secondary immune deficiency, including malignancy (n=53), human immunodeficiency virus infection (n=5) and immunosuppressive treatment (n=13). Mean interval period from clinical presentation to treatment onset was 2.56 (0-8) days. Mean duration of fever was 1.92 (0-6) days, of symptoms 7.29 (2-18) days and of hospitalization 5.39 (0-17) days. Most children (71.6%) had no complications. Among patients with VZV-associated complications, dermatological, respiratory and neurological complications were the most prevalent [6 (8.1%), 5 (6.8%) and 3 (4.1%) patients, respectively]. Fever during the disease course [HR=7.72 (1.86-32.07), p= 0.005) and longer interval period from presentation to treatment onset (HR= 1.68 (1.08-2.61), p=0.021] were associated with higher complication rate in the multivariate analysis. No case of mortality was noted.
Conclusion: Morbidity and mortality of VZV-associated infections among immunocompromised children should be further evaluated in larger cohorts.
