Complete remission of VZV reactivation treated with valganciclovir in a patient with total lymphocyte depletion and acute kidney injury after allogeneic bone marrow transplantation

Varicella zoster virus ( VZV ), a threat for hematopoietic stem cell transplantation ( HSCT ) recipients, is still one of the most common viral pathogens that affect these patients with a reported incidence ranging between 17% and 50% in the post transplantation period. Valganciclovir (V‐ GCV ), a valine ester pro‐drug of GCV orally administrable, has recently shown great activity against CMV infections, but there are no reports of its clinical efficacy against VZV . We here report a case history of a patient with positive serologic test for VZV , who underwent allogeneic HSCT and developed an atypical varicella‐like illness. First‐line therapy with foscarnet had to be discontinued due rapid development of renal impairment (creatinine: 2.60 mg/dL, urea: 130.6 mg/dL) and therefore was switched to V‐ GCV . The renal impairment and skin lesions of the patient fully recovered after few days of therapy, even though the patient had complete lymphocyte depletion. This is the first case of a patient with chickenpox‐like illness treated successfully with V‐ GCV .