Immunocompetent children account for the majority of complications in childhood herpes zoster.

In a 2-year-long active surveillance conducted in all German pediatric hospitals, the incidence of hospitalization because of herpes zoster and the clinical picture of complications in children were assessed. Herpes zoster resulted in hospitalization of 244 children, 78 of whom were considered to be immunocompromised. Zoster ophthalmicus (n=29), meningoencephalitis (n=22), and zoster oticus (n=23) (11 cases had Ramsay Hunt syndrome) accounted for 59% of all complications (n=115). The incidence of hospitalization suggests that at least 1 in every 100 children with herpes zoster is hospitalized and that at least 1 in every 250 immunocompetent children with herpes zoster is hospitalized with complications.