Acute abdomen without cutaneous signs of varicella zoster virus infection as a late complication of allogeneic bone marrow transplantation: importance of empiric therapy with acyclovir

Two patients complained of severe abdominal pain as the first sign of varic ella tester virus infection about 1 year after allogeneic BMT. In case 1, e ruptions, found on the face and chest on admission, became vesicular and di spersed on the third hospital day. Though acyclovir (ACV) was immediately s tarted, he died on the fourth day. In case 2, skin rash was never observed during the clinical course. Laparotomy on the third hospital day revealed m any hemorrhagic spots on the liver surface and mucous membrane of the upper GI tract, indicating disseminated visceral disease. Empiric therapy with A CV was successful.