未滿兩歲長帶狀疱疹的個案報告
 
吳俊鋒¹　劉貴中²　謝奇璋³　王莉惠⁴

 
帶狀疱疹是潛伏在人體的水痘帶狀疱疹病毒再活化所造成。兒童帶狀疱疹並不常見，未滿兩歲更是罕見。本個案為1歲11個月大的女孩，過去未長過水痘，滿一歲時曾打過活性減毒的水痘疫苗。接種後第348天，在施打疫苗的左大腿（第三及第四腰椎的神經皮節）長出帶狀疱疹。經Acyclovir治療後，恢復迅速。依此個案的病史和臨床特徵推測，其帶狀疱疹可能是水痘疫苗所造成。若想確認帶狀疱疹在曾打過水痘疫苗的病人身上，到底是野生株或疫苗株的病毒所造成，最好的方法是做PCR檢驗。根據研究，水痘疫苗的確可能造成帶狀疱疹，但有施打疫苗者，其發生率和症狀均低於未施打疫苗者。整體而言，施打水痘疫苗，不僅能預防水痘，亦能預防帶狀疱疹，施打兩劑保護力更好。
（台灣家醫誌2022; 32: 71-75）DOI: 10.53106/168232812022033201008
 
關鍵詞：兒童帶狀疱疹、水痘疫苗
 

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¹郭綜合醫院家庭醫學科、²皮膚科、⁴兒童過敏免疫科；³成功大學附設醫院兒童過敏免疫科
受理日期：110年5月7日　 修改日期：110年6月8日　　同意刊登：110年8月10日
通訊作者：王莉惠　　　　通訊地址：台南市民生路二段22號　郭綜合醫院小兒科　E-mail: eden7632@gmail.com

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Herpes Zoster in a 23-month-old Girl: A Case Report
 
Jun-Feng Wu¹, Gui-Zhong Liu², Chi-Chang Shieh³ and Li-Hui Wang⁴

 
Herpes zoster, caused by reactivation of the varicella-zoster virus (VZV), is not commonly seen in children, especially in those under 2 years of age. We reported a case of a 23-month-old girl with herpes zoster. She had no personal history of chicken pox. She was immunized with the live attenuated varicella vaccine at 12 months of age. Nevertheless, she developed herpes zoster in the left thigh (L3-L4 dermatomes) around the immunization site 348 days after the varicella vaccination. Her clinical symptoms improved rapidly after acyclovir treatment. Based on the personal history and clinical presentation, it is possible that her herpes zoster was caused by the virus of varicella vaccine. The best way to identify wild-type or vaccine-strain VZV in a herpes zoster patient with a prior history of varicella vaccination is by viral genome detection using polymerase chain reaction (PCR). As previous studies indicate, vaccine-strain herpes zoster can occur after varicella vaccine. However, the incidence and symptoms of herpes zoster occur less often in vaccinated individuals than in unvaccinated ones. In general, varicella vaccine can prevent not only varicella but also herpes zoster. The preventive effect of two-dose varicella vaccination is better than that of one-dose vaccination.
(Taiwan J Fam Med 2022; 32: 71-75) DOI: 10.53106/168232812022033201008
 
Key words: Herpes zoster in children, varicella vaccine
 

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¹Department of Family Medicine, Kuo General Hospital, Tainan; ²Departments of Dermatology, Kuo General Hospital, Tainan; ³Division of Pediatric Allergy and Immunology, National Cheng Kung University Hospital, Tainan; ⁴Division of Pediatric Allergy and Immunology, Kuo General Hospital, Tainan, Taiwan.
Received: May 5, 2021; Revised: June 8, 2021; Accepted: August 10, 2021.