Herpes zoster ophthalmicus is uncommon in children, and diagnosis may be delayed until the typical skin lesions become apparent. Delay in appropriate treatment may result in sight-threatening complications. We report a case of an 18-month-old child in whom we promptly confirmed the clinical suspicion of herpes zoster ophthalmicus by the identification of viral DNA using polymerase chain reaction. This procedure enabled us to administer prompt antiviral treatment, preventing sight-threatening sequelae. We review the literature regarding the possible mechanism of herpes zoster ophthalmicus in immunocompetent children and discuss the role of polymerase chain reaction in its diagnosis.
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