Primary Disseminated Varicella Presenting as an Acute Abdomen

Kim, Susan H.; Haycox, Claire L.

doi:10.1046/j.1525-1470.1999.00055.x

Cited by 13 publications

(5 citation statements)

References 7 publications

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“…The cell-mediated immune response occurs early on during primary VZV infection, containing VZV replication and preventing severe disease [173]. Failure of the cellular responses to halt spread of VZV, which can often occur in immunocompromised patients, can result in VZV visceral dissemination to the lungs, liver, kidneys, and spleen and in progressive life-threatening infection [174][175][176][177][178].…”

Section: Molecular Studies Of Vzv and The Immune System Cellular Immumentioning

confidence: 99%

Molecular studies of Varicella zoster virus

Quinlivan

Breuer²

2006

Rev. Med. Virol.

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VZV is a highly cell-associated member of the Herpesviridae family and one of the eight herpesviruses to infect humans. The virus is ubiquitous in most populations worldwide, primary infection with which causes varicella, more commonly known as chickenpox. Characteristic of members of the alphaherpesvirus sub-family, VZV is neurotropic and establishes latency in sensory neurones. Reactivation from latency, usually during periods of impaired cellular immunity, causes herpes zoster (shingles). Despite being one of the most genetically stable human herpesviruses, nucleotide alterations in the virus genome have been used to classify VZV strains from different geographical regions into distinct clades. Such studies have also provided evidence that, despite pre-existing immunity to VZV, subclinical reinfection and reactivation of reinfecting strains to cause zoster is also occurring. During both primary infection and reactivation, VZV infects several PBMC and skin cell lineages. Difficulties in studying the pathogenesis of VZV because of its high cell association and narrow host range have been overcome through the development of the VZV severe combined immunodeficient mouse model carrying human tissue implants. This model has provided a valuable tool for studying the importance of individual viral proteins during both the complex intracellular replication and assembly of new virions and for understanding the underlying mechanism of attenuation of the live varicella vaccine. In addition, a rat model has been developed and successfully used to uncover which viral proteins are important for both the establishment and maintenance of latent VZV infection.

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Section: Molecular Studies Of Vzv and The Immune System Cellular Immumentioning

confidence: 99%

Molecular studies of Varicella zoster virus

Quinlivan

Breuer²

2006

Rev. Med. Virol.

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“…However, dissemination of the primary infection can occur, particularly in immunocompromised children1,2,3,4,5,6,7). The lungs, liver, brain and heart are usually involved in progressive varicella1).…”

Section: Discussionmentioning

confidence: 99%

“…Varicella-zoster virus (VZV) infection is a self-limited childhood disease1,2). However, it sometimes can be a life-threatening condition, especially in immunocompromised patients such as bone marrow transplant recipients, who are receiving corticosteroids therapy or chemotherapy and patients with human immune deficiency virus infection1,2,3,4,5,6,7,8).…”

Section: Introductionmentioning

confidence: 99%

“…However, it sometimes can be a life-threatening condition, especially in immunocompromised patients such as bone marrow transplant recipients, who are receiving corticosteroids therapy or chemotherapy and patients with human immune deficiency virus infection1,2,3,4,5,6,7,8). Although, it is very rare, VZV infection can be also lead to severe illness in immunocompetent persons2,3,6,7).…”

Section: Introductionmentioning

confidence: 99%

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Use of intravenous immunoglobulin in a disseminated varicella infection in an immunocompromised child

et al. 2014

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Varicella-zoster virus infection can lead to severe illness in immunocompromised patients. Further the mortality rate of disseminated varicella infection is extremely high particularly in immunocompromised children. We report a case of disseminated varicella infection in a child with acute lymphoblastic leukemia who was receiving chemotherapy, but was initially admitted with only for acute abdominal pain. The patient rapidly developed severe complications, including acute respiratory distress syndrome, acute hepatitis, disseminated intravascular coagulation, and encephalopathy. Acyclovir is a highly potent inhibitor of varicella-zoster virus infection. However, owing to rapid disease progression, it might not be sufficient to control a disseminated varicella infection, especially in immunocompromised patients. Immunoglobulin neutralize virus invasion and suppress viremia, acting synergistically with acyclovir. In this case, early administration of acyclovir and a high-dose of immunoglobulin, combined with mechanical respiratory support, proved adequate for treatment of this severe illness.

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“…Kim and Haycox reported a case of varicella presenting with acute abdominal pain and pancreatitis, with appearance of the rash after three days of abdominal pain, in a young boy with stage IV neuroblastoma. 5 Szabo et al published a case of VZV presenting with abdominal pain and a syndrome of inappropriate antidiuretic hormone secretion (SIADH), with a rash that developed on day nine of abdominal pain, in a bone marrow transplant patient with chronic myeloid leukemia. 6 Magi reported a case of varicella as the cause of abdominal pain followed by fever and neurological deterioration, with a vesiculopustular rash that progressively became hemorrhagic and purpuric, in a patient with non-Hodgkin's lymphoma on chemotherapy.…”

Section: Discussionmentioning

confidence: 99%