Ramsay Hunt Syndrome developed following varicella vaccination: A pediatric case

Abstract

Ramsay Hunt Syndrome (RHS) was first described by J.Ramsay Hunt in 1907. Ramsay Hunt Syndrome also known as Herpes Zoster Oticus consists of facial paralysis accompained by the presence of erythematous vesicles on ear and/or oral mucosa and otalgia. This syndrome is most common in adults and older children and very rare in young children. Affected children display mild symptoms than adults. Following the primary infection, Varicella Zoster Virus (VZV) becomes latent in the cells of the sensory ganglia and a reactivation associated with supressed cell-mediated immunity may occur after a period of time, resulting in RHS. Although subfebrile fever and chickenpox-like rash can happen from Varicella vaccine, the risk of RHS is extremely rare after immunization. It has been reported that the microorganism introduced into the body by means of live attenuated varicella vaccine becomes activated and causes varicella especially in immunocompromised patients. Following receipt of varicella vaccine, RHS has also been reported to occur rarely. We, herein, report the case of 13-month-old female patient with infantile nephrotic syndrome that who developed RHS after her immunization with vaccine in combination with varicella other live vaccines.