Sy. Rogers et al., VISCERAL VARICELLA-ZOSTER INFECTION AFTER BONE-MARROW TRANSPLANTATIONWITHOUT SKIN INVOLVEMENT AND THE USE OF PCR FOR DIAGNOSIS, Bone marrow transplantation, 15(5), 1995, pp. 805-807
A 41-year-old patient with acute myeloid leukemia was transplanted fro
m an HLA-identical but ABO-incompatible sibling. The post-transplant c
ourse was complicated by pure erythrocyte aplasia and mild chronic gra
ft-versus-host disease. Eleven months after transplant while on steroi
d therapy she developed abdominal pain rapidly followed by fatal fulmi
nant hepatic failure. Varicella zoster virus (VZV) was detected using
the polymerase chain reaction from blood and liver obtained at necrops
y even though no skin manifestations of VZV were present. This case co
nfirms previous reports of visceral VZV infection in the absence of sk
in lesions thus emphasising the importance of suspecting the presence
of VZV in this clinical setting and outlines the possible value of PCR
in the rapid diagnosis of infection.