Varicella zoster virus infection in pediatric oncology patients

OBJECTIVES

Varicella-zoster virus (VZV) infection may lead to serious complications and death in immunocompromised patients. Although there were researches which aim to decrease complications by vaccination and antiviral prophylaxis; there is stil no definitive protocols. In this study, we wanted to determine the frequency and clinical progress of VZV infections in patients with malignant diseases in whom prophylaxis was not used routinely during chemotherapy.

METHODS

Datas of 30 patients (12 females, 18 males; median age 6 years; range 1 to 13 years) in pediatric oncology department who were exposed to VZV during their chemotheraphy between January 2001 and December 2004 were retrospectively examined.

RESULTS

In 23 of patients there was fever. Skin lesions were widespread, but they were non-hemorhogic or infected and were crusted approximotely in 6.5 days. In one patient liver enzymes were eleveted. In others systemic complications were not seen. Patients taking approximately 8 days of intravenous acyclovir were discharged from hospital without any complication. In our patients VZV infections were benignly progressed. Early treatment with acyclovir might decrease the complications. But in spite of treatment there might be seriously progressed cases.

CONCLUSION

In our country where vaccination for VZV is not performed routinely to healthy children; observation of large series with multidisciplinary studies of oncology and infectious diseases clinics may aid us to determine if prophylaxis is needed or not.

Keywords: Acyclovir; child; neoplasms/immunology/therapy; varicella zoster