Disseminated varicella with multiorgan failure in an immunocompetent adult

Beby‐Defaux, Agnès; Chatellier, D.; Bourgoin, A.; Robert, R.; Ruckes, Tobias; Agius, G.

doi:10.1002/jmv.21447

Cited by 28 publications

(21 citation statements)

References 15 publications

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“…The increased levels of SVV DNA in BAL cells compared to PBMCs are consistent with the severity of VZV infection seen in lungs of humans with varicella [47],[48],[49],[50]. The presence of SVV ORF61 transcripts was the only difference between VZV and SVV latency.…”

Section: Discussionsupporting

confidence: 68%

Simian Varicella Virus Infection of Rhesus Macaques Recapitulates Essential Features of Varicella Zoster Virus Infection in Humans

et al. 2009

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Simian varicella virus (SVV), the etiologic agent of naturally occurring varicella in primates, is genetically and antigenically closely related to human varicella zoster virus (VZV). Early attempts to develop a model of VZV pathogenesis and latency in nonhuman primates (NHP) resulted in persistent infection. More recent models successfully produced latency; however, only a minority of monkeys became viremic and seroconverted. Thus, previous NHP models were not ideally suited to analyze the immune response to SVV during acute infection and the transition to latency. Here, we show for the first time that intrabronchial inoculation of rhesus macaques with SVV closely mimics naturally occurring varicella (chickenpox) in humans. Infected monkeys developed varicella and viremia that resolved 21 days after infection. Months later, viral DNA was detected only in ganglia and not in non-ganglionic tissues. Like VZV latency in human ganglia, transcripts corresponding to SVV ORFs 21, 62, 63 and 66, but not ORF 40, were detected by RT-PCR. In addition, as described for VZV, SVV ORF 63 protein was detected in the cytoplasm of neurons in latently infected monkey ganglia by immunohistochemistry. We also present the first in depth analysis of the immune response to SVV. Infected animals produced a strong humoral and cell-mediated immune response to SVV, as assessed by immunohistology, serology and flow cytometry. Intrabronchial inoculation of rhesus macaques with SVV provides a novel model to analyze viral and immunological mechanisms of VZV latency and reactivation.

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Section: Discussionsupporting

confidence: 68%

Simian Varicella Virus Infection of Rhesus Macaques Recapitulates Essential Features of Varicella Zoster Virus Infection in Humans

et al. 2009

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“…In our patient, widespread viremia may have caused the rhabdomyolysis and meningoencephalitis though the blood brain barrier [2,8]. VZV DNA can be detected during the acute phase, and viremia usually declines during the early phase of acyclovir therapy and becomes undetectable 14 days after Varicella onset [7,10]. In our patient, the disappearance of viral DNA during the convalescence phase reinforced our diagnosis of VZV reactivation meningoencephalitis accompanied by rhabdomyolysis.…”

Section: Discussionsupporting

confidence: 76%

“…The clinical course of rhabdomyolysis was favorable in our patient, but rhabdomyolysis related to VZV infection requires careful management [3][4][5][6][7]. Rhabdomyolysis itself can produce not only life-threatening complications such as renal failure, intravascular disseminated coagulation, and hyperkalemia, but also nephrotoxicity from the acyclovir, which is introduced for treating the VZV infection, but may precipitate renal failure [1].…”

Section: Discussionmentioning

confidence: 98%

“…An activated immune system may induce harmful cytokines with an efflux of myoglobin from the muscles, causing rhabdomyolysis [5]. There has been a few case reports of rhabdomyolysis associated with VZV infection; however, considering that CK levels are not routinely obtained for VZV infections, mild cases of rhabdomyolysis might have been underdiagnosed [1,[4][5][6][7].…”

Section: Discussionmentioning

confidence: 99%

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Varicella zoster virus meningoencephalitis accompanied by rhabdomyolysis without skin eruption

Kim

2011

Neurol Sci

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We report a case of a 38-year-old man with a Varicella zoster virus (VZV) reactivation who manifested meningoencephalitis accompanied by rhabdomyolysis without a skin eruption. During the acute phase, VZV DNA was detected in serum and cerebrospinal fluid (CSF) by the polymerase chain reaction (PCR). After 16 days, all symptoms and signs resolved, and follow-up PCR studies revealed negative conversion of VZV in the serum and CSF. We discuss the possible underlying mechanism of VZV reactivation in our patient. This is the first case report of VZV reactivation meningoencephalitis accompanied by rhabdomyolysis without skin eruption demonstrated by viral DNA in the serum and CSF.

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“…The abovementioned patient was an immunocompetent healthy adult with no known major illnesses. The literature reports few cases of fulminant disseminated involvement of varicella in young immunocompetent adults who developed hepatitis, severe pneumonia, rhabdomyolysis, and disseminated intravascular coagulation, followed by encephalopathy and multiorgan failure [11].…”

Section: Case Reportmentioning

confidence: 99%

An Association of Varicella Zoster Virus, Facial Palsy, and Meningitis in a Young Immunocompetent Male

Ashour¹,

Obeidat²,

Azrieh³

et al. 2020

Case Rep Neurol

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Varicella zoster is a secondary infection caused by the virus of chickenpox, after becoming latent in neurons of dorsal root ganglia or trigeminal ganglia. Varicella zoster virus (VZV) can be reactivated years later to produce shingles (zoster), generally in immunocompromised adults to produce neurological deficits and rash. Meningeal involvement of VZV is also reported and can be diagnosed. Herein, we report a 39-year-old immunocompetent male adult with a rare manifestation caused by VZV. The report is an association between facial nerve palsy and a polymerase chain reaction-confirmed VZV meningitis, even without the dermal typical rash. The patient eventually recovered after receiving acyclovir intravenously.

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Disseminated varicella with multiorgan failure in an immunocompetent adult

Cited by 28 publications

References 15 publications

Simian Varicella Virus Infection of Rhesus Macaques Recapitulates Essential Features of Varicella Zoster Virus Infection in Humans

Simian Varicella Virus Infection of Rhesus Macaques Recapitulates Essential Features of Varicella Zoster Virus Infection in Humans

Varicella zoster virus meningoencephalitis accompanied by rhabdomyolysis without skin eruption

An Association of Varicella Zoster Virus, Facial Palsy, and Meningitis in a Young Immunocompetent Male

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