Although acute liver failure due to the varicella-zoster virus is rare
, it is frequently fatal. Immunologic impairment is a significant pred
isposing factor. Classic symptoms at presentation are rash, abdominal
pain, and fever. After some days patients go on to develop full-blown
liver failure. The diagnosis can be confirmed by histological examinat
ion and electron microscopy with fluorescent staining, immunohistochem
istry, and in situ hybridization of the liver. In cases of high suspic
ion, acyclovir therapy should not be delayed.