Age: 3.0
Sex: M
Vaccine: VARCEL
Symptoms: Conjunctivitis, Eye pain, Herpes zoster, Infection, Photophobia
Clinical narrative: Information has been received from a physician concerning a 3 year old male pt with no past medical history and no known drug allergies who on 7/30/98 was vaccinated in the right thigh with varicella virus vaccine live. There was no concomitant medication. Subsequently, the pt experienced shingles on the left side of his nose, forehead and eye. It was noted that the child was adopted at 1 year of age from another country and that the child did not have chickenpox prior to the adoption. It was also noted that the physician was not sure if it would have been noticed by the child's care givers there. The physician reported that on 3/23/01, 2 specimens had been collected from a vesicle for PCR analysis. Follow-up information has been received from a physician who reports that there was no rash at the site of injection, post vax. It was noted that the pt's maximum temperature was 101F and that on an unknown date, the pt recovered. It was also noted that the specimen obtained was inadequate to process for PCR analysis. Follow up information has been received from a physician who reports that there was no rash at the site of injection post-vaccination. It was noted that the patient's maximum temperature was 101 and that on an unknown date the patient recovered. It was also noted that the specimen obtained was inadequate to process for PCR analysis. Subsequently, the patient's experience was reported in a published article, titile as state above, that the patient had been "previously well", and had a historyi of adoption at 9 months of age and vesicular eruption (probable varicella) at 6 month of age who, at 12 months of age was vaccinated with a dose of varicella virus vaccine live. Subsequently, the patient presented to his doctor with a 3 day history of left eye painand photophobia. There was no rash. He was evaluated by his pediatrician who referred him to an ophthalmologist because of conjuctival injection with severe ey pain. A slit lamp examination revealed slight corneal staining. He was treated for a corneal abrasion with patching and erythromycin eye ointment. During the next 2 days, the eye pain persisted, and he developed a fever and a rash. He was referred to infectious disease. On the left ophthalmic branch of the trigeminal nerve. He was photophobic, the bulbar conjunctiva was injected and there was a clear conjunctival discharge. The remainder of the physical examination was normal. Scrapings from the base of a vesicle o the tip of the nose was VZV DFA-postibe. He was examined by an opthalmologist who found small mucous plaque involving the cornea. The patient was hospitalized and treated with intravenous acyclovir and pain medication. He improved greatly during the next 3 days and was discharged to receive oral acyclovir (20mg/kg every 6 hours) therapy for 7 days. Eye pain recurred the week after stopping the acyclovir. He was evaluated by his opthalmologist who found faint corneal sromal abnormalities and white blood cells in the anterior chamber (diffuse uveitis). The facial rash had resolved. He was treated with atropine and prednisone eye drops for 7 days during which the pain resolved. It was reported that the patient had been followed for two years and had remained well. No further information is available.