Herpes zoster in infancy after intrauterine exposure to varicella zoster virus: report of two cases.

Herpes zoster occurs very rarely in infancy. We report two infants who developed zoster-like lesions at three and seven months of age. They had no history of chickenpox after birth. Both mothers acquired varicella infection during their sixth month of pregnancy. The crops of vesicular rashes appeared in right L1-3 dermatomes in one patient and left V3, C2 dermatomes in the other. Laboratory findings demonstrated a four-fold rise in varicella zoster virus (VZV) IgG antibody in one patient and positive VZV IgM antibody in the other. Both infants received acyclovir treatment and the skin lesions healed rapidly without sequela. In infancy, herpes zoster may be the primary clinical manifestation of reactivation of latent VZV infection acquired transplacentally during intrauterine life.