Chickenpox is the primary infection caused by the Varicella-Zoster Virus (VZV) in non-immune individuals. After primary infection, VZV remains latent in the dorsal root ganglia and can be reactivated by factors or conditions that suppress immune function, resulting in HZ. Early diagnosis and prompt antiviral treatment can reduce the severe complications of shingles [4]. Therefore, identifying risk factors for shingles is vital.

There is a strong correlation between aging/immunosuppression and the reactivation of the virus [1,2,4]. However, few publications address other risk factors, such as physical injury [1,3,5-8]. In a systematic review, Marra et al. demonstrated that physical trauma significantly increases the risk of the disease [1]. White et al. also emphasized the association between the onset of the zoster rash and previous physical trauma [8]. The dermatomal distribution of the rash often corresponds to the area of prior trauma, with the highest risk occurring in the first week after injury [8, 9]. Reported cases induced by injury include cryotherapy [10], liver biopsy [11], intubation [12], knee arthroplasty [13], and axillary nerve block [14]. To our knowledge, only one case report exists regarding HZ development related to nursing trauma [3]. Shingles may be triggered by traumatic nerve stimulation leading to viral reactivation in the dorsal root ganglion [5], or directly from trauma and subsequent virus-induced local immune dysfunction.

A “nursing strike” refers to a sudden refusal to breastfeed [3,15]. Infant-related factors include infection, teething, and pain, while maternal factors include breast infection, anxiety, or medication [15]. We hypothesize that the nursing strike in our case was caused by the mother’s lesions and pain in the nursing region. Unvaccinated infants may present with chickenpox after contact with zoster lesions [4]. Although the exact transmission route in our case was not determined, the baby developed mild varicella and received appropriate care.