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Fatal disseminated visceral varicella zoster virus infection in a renal transplant recipient
Author(s) -
Loftus Michael J.,
Yong Michelle K.,
Wilson Scott,
Peleg Anton Y.
Publication year - 2019
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.13062
Subject(s) - medicine , rash , immunosuppression , varicella zoster virus , abdominal pain , transplantation , pancreatitis , hepatitis , immunology , virus
We report a case of fatal disseminated varicella zoster virus (VZV) with delayed–onset rash in a 66‐year‐old female more than 2 years following uncomplicated deceased donor renal transplantation. Whilst on a stable regimen of maintenance immunosuppression, the patient presented with chest and abdominal pain with concomitant hepatitis and pancreatitis. After pursuing multiple other potential causes of her symptoms, the correct diagnosis of VZV was only suspected after the development of a widespread vesicular rash—11 days after her initial symptoms. Despite antiviral therapy and inotropic support in the intensive care unit, the patient died. Simultaneous VZV hepatitis and pancreatitis in solid organ transplant recipients is uncommon. The new inactivated VZV vaccines have the potential to prevent post‐transplant infections, with promising early clinical data on safety and efficacy in renal transplant recipients. VZV is an important preventable infection that should be considered in immunocompromised patients, even in the absence of rash.