Multiple herpetic whitlow lesions in a 4-year-old girl: case report and review of the literature

Citation
G. Szinnai et al., Multiple herpetic whitlow lesions in a 4-year-old girl: case report and review of the literature, EUR J PED, 160(9), 2001, pp. 528-533
Citations number
39
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Pediatrics,"Medical Research General Topics
Journal title
EUROPEAN JOURNAL OF PEDIATRICS
ISSN journal
0340-6199 → ACNP
Volume
160
Issue
9
Year of publication
2001
Pages
528 - 533
Database
ISI
SICI code
0340-6199(200109)160:9<528:MHWLIA>2.0.ZU;2-O
Abstract
Herpetic whitlow is a herpes simplex virus type 1 or 2 infection of the fin gers characterised by erythema and painful, non-purulent vesicles. In child ren it typically occurs after auto-inoculation from herpes stomatitis, herp es labialis or genitalis. Occasionally, person-to-person transmission occur s from family members with herpes labialis. We report a 4-year-old girl wit h multiple herpetic whitlows secondary to herpetic stomatitis and present a review of the medical literature based on a systematic MEDLINE search of p ublished paediatric patients (English, French and German language). Of 42 i dentified patients, 72% were younger than 2 years, most had endogenous or e xogenous inoculation of herpes simplex virus type 1 and 65% were initially misdiagnosed as having "bacterial felon". Recurrences were reported in 23%. Conclusion: herpetic whitlow should be suspected based on clinical signs. Specific diagnosis can be made by polymerase chain reaction or culture. The high rate of misdiagnosed cases indicates that this entity is not sufficie ntly known. Lesions are self-limited; surgical interventions can be harmful and should be avoided. Recurrences occur as, frequently as in adults.