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The Journal of pediatrics · Oct 2012
Eczema herpeticum in children: clinical features and factors predictive of hospitalization.
- Nadia Jennifer Chiara Luca, Irene Lara-Corrales, and Elena Pope.
- Division of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
- J. Pediatr. 2012 Oct 1;161(4):671-5.
ObjectiveTo describe the clinical characteristics of pediatric patients with eczema herpeticum and to determine the predictors of hospitalization, and recurrence and repeat episodes.Study DesignA retrospective cohort study of patients 0-18 years of age diagnosed with eczema herpeticum between May 2000 and April 2009 was carried out at a tertiary pediatric care center in Canada. Seventy-nine patients were included. The primary outcome was hospitalization; secondary outcomes were recurrent and repeat episodes of eczema herpeticum.ResultsAt presentation, 76% of 79 patients with eczema herpeticum had a generalized eruption, 56% had fever, 37% had systemic symptoms, and 10% had eye involvement (keratoconjunctivitis). Forty-five patients (57%) were hospitalized. Predictors for hospitalization included male sex (OR = 3.09; 95% CI, 1.20-7.95, P = .017), fever (OR = 5.75; 95% CI, 2.17-15.26, P < .001), systemic symptoms (OR = 2.84; 95% CI, 1.06-7.62, P = .035), and age <1 year (OR = 7.17; 95% CI, 2.17-23.72, P = .001). Recurrence rate (<1 month) was 8.9% and rate of repeat episodes (>1 month) was 16%. Hospitalized patients were more likely to have a repeat episode (OR = 8.25; 95% CI, 0.99-68.69, P = .05). Patients with a previous history of eczema herpeticum had increased likelihood of early recurrence (OR = 6.80; 95% CI, 0.99-46.62, P = .05) and repeat episodes (OR = 9.43; 95% CI, 1.52-55.9, P = .01).ConclusionsPredictors of hospitalization in this cohort included male sex, age <1 year, fever, and systemic symptoms at presentation. Hospitalized patients may be at risk for repeat episodes of eczema herpeticum.Copyright © 2012 Mosby, Inc. All rights reserved.
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