Pediatric herpes zoster: should I be concerned for immunodeficiency? A review
Bibliographic record
Abstract
Herpes zoster (HZ), caused by reactivation of varicella-zoster virus (VZV), is an uncommon cause of rash in pediatrics, which can lead to concerns of an underlying immunodeficiency. We reviewed studies on HZ in pediatric patients. The diagnosis of HZ can usually be established based on clinical and epidemiological features. HZ is associated with T-cell immune defects that can be secondary to infections with HIV, tuberculosis, and other pathogens, as well as conditions such as diabetes, malnutrition, cancer, or primary immunodeficiency. Important clinical clues indicating that HZ is due to an underlying immunodeficiency include recurrent HZ during a short period; disseminated HZ; new lesions more than a week after presentation; prolonged course despite antiviral medications; a history of recurrent, invasive, or prolonged infections by other pathogens; and a family history of immunodeficiency or consanguinity. Reassuring features include exposure to VZV prior to 1 year of age or a compromised or incomplete VZV vaccination schedule. Initial laboratory analysis may include confirmation of normal newborn screening for profound T-cell immunodeficiency; a complete blood count with differential, quantitative serum immunoglobulins; lymphocyte subset analysis; and the presence of IgG to VZV. In children previously vaccinated for VZV, the possibility of vaccine-type HZ needs to be considered. In conclusion, isolated and uncomplicated childhood HZ is unlikely to be the sole harbinger of an underlying immunodeficiency. Therefore, most children with HZ can be adequately diagnosed through medical history and readily available laboratory evaluations. The presence of concerning clinical or laboratory features should prompt an evaluation by an experienced specialist.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".