Author:
Zhang Wei,Ruan Qiao-ling,Yan Fang,Hu Yue-kai
Abstract
Abstract
Background
Varicella is normally a self-limited childhood disease caused by varicella-zoster virus infection. However, it sometimes causes severe diseases, especially in immunocompromised individuals. We report a case of severe varicella in a young woman.
Case presentation
A 19-year-old woman presented to the emergency department with abdominal pain and a rash after taking methylprednisolone for 2 weeks for systemic lupus erythematosis. The laboratory data showed leukocytosis, thrombocytopenia, an elevated level of the liver transaminases and disseminated intravascular coagulation. Computed tomography of the abdomen revealed multiple air-fluid levels in the intestines. Hemorrhagic varicella was considered and antiviral therapy as well as immunoglobin were applied. Her condition deteriorated and she eventually died due to multi-organ failure and refractory shock. Next-generation sequencing performed on fluid from an unroofed vesicle confirmed the diagnosis of varicella.
Conclusion
In its severe form, VZV infection can be fatal, especially in immunocompromised patients. Hemorrhagic varicella can be misdiagnosed by clinicians because of unfamiliar with the disease, although it is associated with a high mortality rate. In patients with suspected hemorrhagic varicella infection, antiviral therapies along with supportive treatment need to be initiated as soon as possible in order to minimize the case fatality rate.
Publisher
Springer Science and Business Media LLC
Reference30 articles.
1. Akiyama M, Kobayashi N, Fujisawa K, Eto Y. Disseminated varicella-zoster virus infection in a girl with T-lineage acute lymphoblastic leukemia. Pediatr Blood Cancer. 2007;48(7):716.
2. Wu CT, Tsai SC, Lin JJ, Hsia SH. Disseminated varicella infection in a child receiving short-term steroids for asthma. Pediatr Dermatol. 2008;25(4):484–6.
3. Rommelaere M, Marechal C, Yombi JC, Goffin E, Kanaan N. Disseminated varicella zoster virus infection in adult renal transplant recipients: outcome and risk factors. Transplant Proc. 2012;44(9):2814–7.
4. Schiller GJ, Nimer SD, Gajewski JL, Golde DW. Abdominal presentation of varicella-zoster infection in recipients of allogeneic bone marrow transplantation. Bone Marrow Transplant. 1991;7(6):489–91.
5. Mpaka M, Karantanas AH, Zakynthinos E. Atypical presentation of varicella-zoster virus encephalitis in an immunocompetent adult. Heart Lung. 2008;37(1):61–6.
Cited by
12 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献