Herpes simplex virus type 2 in a child

Herpes simplex virus type 2 in a child: a case of rare rash localization.

Parents brought in their 4-year-old child who developed a rash on the sole of the right foot.

The blisters, ranging in size from 5 mm to 1.5 cm, containing clear fluid, resembled calluses, causing itching and preventing the girl from stepping on it due to pain.

The rash first appeared 2 years ago and recurred every 1-2 months, exclusively on the right foot. It was not associated with medication or food intake. The child was seen by a dermatologist due to the eruptions.

Family History:
In the family, parents experience recurrent labial herpes every 1-2 years, affecting the lips. The child’s disease exacerbation did not coincide with the parents’ eruptions.

Medical History:
The girl has been under pediatric care since birth. She had respiratory tract infections 1-2 times a year. There are no chronic illnesses, and she did not have chickenpox. Routine vaccinations were administered.

Pregnancy History:
During pregnancy, the mother did not experience herpes simplex virus infections.

The child has a normal build and eats well. The skin is pale. On the sole of the right foot, there are rash elements measuring 1 cm with clear contents.

Laboratory Tests:
The patient underwent laboratory tests, including PCR and ELISA tests for herpes simplex virus, and vitamin D levels.

Cutaneous-mucosal form of recurrent infection caused by herpes simplex virus type 2 (HSV-2), accompanied by vitamin D deficiency.

The girl was prescribed Acyclovir, quartz therapy, and vitamin D supplementation. Additionally, parents were advised to consult an immunologist.

Follow-up and Prognosis:
Dynamic observation for 3-6 months is necessary to evaluate the prescribed therapy, as well as to check the patient’s immune status. If immune system imbalance is confirmed, treatment strategy may need to be adjusted.

Infection caused by herpes simplex virus is chronic, as the virus remains in the human cells forever. Exacerbation is associated with weakened immunity. Prolonged use of antiviral drugs cannot completely eliminate symptoms but can reduce disease recurrence. To boost immunity, it is necessary to restore the vitamin D level.

This clinical case demonstrates the importance of modern laboratory diagnostics used to confirm the diagnosis. For example, PCR diagnostics allows to reliably establish the cause of the disease. Herpes simplex virus type 2 is rarely found in children, as is the localization of the rash on the sole of the foot.