Periorbital eczema herpeticumBMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g2057 (Published 19 March 2014) Cite this as: BMJ 2014;348:g2057
- Sheetal Shukla, resident physician, postgraduate year 11,
- Roshel K E Graham, resident physician, postgraduate year 22,
- Yee Aye, pediatric infectious disease fellow3,
- LaShonda Y Spencer, assistant professor of pediatrics3,
- Cynthia H Ho, assistant professor of clinical medicine and pediatrics2
- 1Department of Pediatrics, Los Angeles County and University of Southern California Medical Center, Los Angeles, CA, USA
- 2Departments of Internal Medicine and Pediatrics, Los Angeles County and University of Southern California Medical Center, Los Angeles, CA 90033, USA
- 3Department of Pediatrics, Division of Infectious Diseases, Los Angeles County and University of Southern California Medical Center, Los Angeles, CA, USA
- Correspondence to: C H Ho
A 2 year old girl with atopic dermatitis presented after three days of fever and periorbital vesiculopustular lesions. Culture of the vesicles identified herpes simplex virus type 1 (HSV-1). Secondary bacterial infection was present. Primary infection or reactivation of HSV in patients with compromised skin integrity is known as eczema herpeticum. Periorbital involvement is uncommon, and HSV should be differentiated from herpes zoster ophthalmicus. Varicella zoster virus follows dermatomes, so bilateral involvement should raise concern for HSV infection. Ophthalmological consultation is advised because complications can threaten vision. In our patient, ophthalmological examination and computed tomography did not detect orbital involvement. After four days of intravenous aciclovir and 10 days of oral treatment the lesions completely resolved.
Cite this as: BMJ 2014;348:g2057
Parental consent obtained.