LETHAL COURSE OF VARICELLA AFTER KIDNEY-T RANSPLANTATION

We report the case of a seven year old girl presenting with varicella infection 14 days after kidney transplantation. Cramp-like abdominal p ain and a subileus were the first symptoms. Enemas did not relieve the symptoms, and the following laparotomoy with Tenckhoff catheter expla ntation was performed which did not reveal any pathologic abnormalitie s. Two days after the beginning of abdominal pain an unspecific papula r rash developed. Further twelve hours later skin vesicles appeared an d varicella-zoster virus was isolated from their fluid. Despite high d ose administration of aciclovir and varicella-zoster immune globulin f urther visceral dissemination occurred and finally lead to liver failu re and intravascular coagulopathy. The patient died 18 days after kidn ey transplantation from multiorgan failure. Discussion: On the backgro und of this lethal varicella infection we emphasize the complications and unusual manifestations in immunocompromised children. Therefore, a ctive immunization is indicated in seronegative patients awaiting orga n transplantation.