Paediatric varicella choroiditis

E ditor ,-Unifocal choroiditis occurs in children and adults with primary (chickenpox) and secondary varicella zoster virus (VZV) infection. 1 Current recommendations by the American Academy of Pediatrics do not include the routine use of oral aciclovir for uncomplicated varicella in otherwise healthy children; individual cases, however, may justify a "modest clinical benefit" from oral aciclovir therapy, provided it can be initiated within the first 24 hours of illness. 2 We describe here an otherwise healthy child with chickenpox who developed a unilateral, unifocal choroiditis with overlying serous detachment of the macula. Barondes et al have, however, described acute retinal necrosis (ARN) in a healthy man 2 weeks after diffuse varicella eruption, where aciclovir and corticosteroids were associated with a favourable outcome. 3 Kelly and Rosenthal also describe multifocal choroiditis in an otherwise healthy adult with primary VZV infection, where oral aciclovir resulted in regression of lesions. 4 The patient described here is unusual in that the choroiditis was unilateral, unifocal, and involved the macula.