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Eczema Herpeticum in Children: Clinical Features and Factors Predictive of Hospitalization

Luca NJC et al. – Predictors of hospitalization in this cohort included male sex, age <1 year, fever, and systemic symptoms at presentation. Hospitalized patients may be at risk for repeat episodes of eczema herpeticum.

Methods
  • A retrospective cohort study of patients 0-18 years of age diagnosed with eczema herpeticum between May 2000 and April 2009 was carried out at a tertiary pediatric care center in Canada. Seventy-nine patients were included.
  • The primary outcome was hospitalization; secondary outcomes were recurrent and repeat episodes of eczema herpeticum.

Results
  • At presentation, 76% of 79 patients with eczema herpeticum had a generalized eruption, 56% had fever, 37% had systemic symptoms, and 10% had eye involvement (keratoconjunctivitis).
  • Forty-five patients (57%) were hospitalized. Predictors for hospitalization included male sex (OR = 3.09; 95% CI, 1.20-7.95, P = .017), fever (OR = 5.75; 95% CI, 2.17-15.26, P < .001), systemic symptoms (OR = 2.84; 95% CI, 1.06-7.62, P = .035), and age <1 year (OR = 7.17; 95% CI, 2.17-23.72, P = .001).
  • Recurrence rate (<1 month) was 8.9% and rate of repeat episodes (>1 month) was 16%.
  • Hospitalized patients were more likely to have a repeat episode (OR = 8.25; 95% CI, 0.99-68.69, P = .05).
  • Patients with a previous history of eczema herpeticum had increased likelihood of early recurrence (OR = 6.80; 95% CI, 0.99-46.62, P = .05) and repeat episodes (OR = 9.43; 95% CI, 1.52-55.9, P = .01).
[more...]

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