Fatal visceral disseminated varicella-zoster virus infection in a renal transplant recipient: A case report

Abstract

BACKGROUND Visceral disseminated varicella-zoster virus (VZV) infection is a rare but life-threatening disease. In transplant recipients with VZV infection, visceral dissemination may develop without skin eruptions, which leads to the failure of early diagnosis. CASE SUMMARY The patient was a 33-year-old male renal recipient who was referred to our hospital with severe upper abdominal pain of 3-d duration. On admission, the patient rapidly developed septic shock and multiple organ dysfunction syndrome with liver dysfunction and acute kidney injury. Next-generation sequencing of peripheral blood yielded 39224 sequence reads of VZV, and real-time polymerase chain reaction for VZV was positive, with 1.2 × 10 7 copies/mL. The final diagnosis was visceral disseminated VZV infection. Acyclovir and supportive therapy were started, but the patient died of severe visceral organ damage 16 h after admission. CONCLUSION Visceral disseminated VZV infection is possible in renal transplant recipients presenting abdominal pain and rapidly-evolving organ damage without skin involvement.

Seroprevalence of Measles, Mumps, Rubella, and Varicella-Zoster Virus and Seroresponse to the Vaccinations in Adult Solid Organ Transplant Candidates

“…13 Herpes zoster is commonly seen in SOT recipients 14 and disseminated disease with multiorgan involvement of varicella-zoster virus (VZV) is a reported entity in solid organ transplantation. 15,16 This highlights the importance of the need for vaccinations for these infections. MMRV infections can be particularly difficult to manage in SOT recipients, especially when they do not have immunity against these pathogens.…”

Severe varicella-zoster virus meningoencephalomyelitis coexisting with visceral disseminated varicella-zoster virus infection in a patient with lupus nephritis: A case report

“…[12,13] Visceral organ involvement may present as severe abdominal pain, hepatitis, pancreatitis, pneumonia, and other symptoms. [6,[14][15][16] Herein, we report a rare case of severe VZV meningoencephalomyelitis with visceral disseminated VZV infection in a patient with lupus nephritis (LN) by metagenomic next-generation sequencing (mNGS).…”