An adult with hemorrhagic varicella co-infects with cytomegalovirus:A case report

Abstract

Background Hemorrhagic varicella(HV) is a rare disease with high mortality in adults. Thus far,approximately 4 cases have been reported. Occasional cases of HV have been reported in adults with hemopathy or other diseases. There only one case described simultaneous reactivation of cytomegalovirus in a chickenpox adult but we are not aware of any description of the changes in liver function indicators of the patient. This is very regrettable for that CMV infection can further exacerbate liver failure and increase mortality.Here we describe a patient with hemorrhagic varicella co-infection with cytomegalovirus and provide a specific description of the indicators of liver damage.Case Presentation: We report the case of a 25-year-old male with HV.He had a history of nephrotic syndrome generally controlled with orally administered prednisone,50mg per day for two months.The patient presented to the emergency room with a complaint of abdominal pain and hemorrhagic vesicles on his body for 3 days.And doctors were unable to make a clear diagnosis.On the first day of hospitalization, the leukocyte count was 20.96/L. So he was given broad-spectrum antibiotic treatment.At the same time, the quantitative analysis of cytomegalovirus DNA was IU/ml in his plasma,so he was treated with intravenous administered ganciclovir. However,he died due to rapidly worsening symptoms. Within one week of the patient's death, chickenpox gradually developed in the doctors and nurses who came into contact with him. In situations like this We speculated that the diagnosis of this patient should be rare hemorrhagic varicella.Conclusions Rapid recognition and appropriate treatment of adult HV are needed to improve the prognosis.