VARICELLA-ZOSTER GASTRITIS IN A BONE-MARROW TRANSPLANT RECIPIENT

A case is reported of a patient who had previously undergone autologou s bone marrow transplantation for recurrent Hodgkin's disease. The pat ient developed a generalised vesicular skin eruption. The clinical dia gnosis was of disseminated shingles. Herpes viral particles were ident ified within the vesicular fluid by electron microscopy and using a sp ecific monoclonal antibody to varicella tester virus (VZV), positive i mmunofluorescence was detected in scrapings from the base of a vesicle . Gastroscopy and biopsy were performed because of severe abdominal pa in and vomiting. The histological features were of non-specific active inflammation. Despite the histological absence of viral inclusions el ectron microscopy of the gastric biopsy revealed the presence of intra nuclear herpes viral particles with a diameter of 90-100 nm. VZV speci fic DNA was detected by the polymerase chain reaction in the gastric b iopsy extract. The patient was treated with acyclovir and made a full recovery.