Patients with disseminated herpes tester may present with severe abdominal
pain that results from visceral involvement of varicella-zoster-virus infec
tion. In the absence of cutaneous eruptions of herpes tester, visceral herp
es tester is extremely difficult to diagnose. This diagnostic difficulty ha
s the potential to cause devastating delays in treatment. We report a case
series of four patients with visceral herpes roster in whom large concentra
tions of DNA from varicella tester virus were detectable in blood by PCR be
fore signs of infection appeared on the skin, thus enabling early diagnosis
and treatment.