2018
DOI: 10.12998/wjcc.v6.i13.659
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Successful rescue of acute liver failure and hemophagocytic lymphohistiocytosis following varicella infection: A case report and review of literature

Abstract: Herein we report a case of acute liver failure (ALF) and hemophagocytic lymphohistiocytosis (HLH) induced by varicella infection, successfully rescued by a combination therapy of acyclovir, supportive care, and immunosuppression with dexamethasone and etoposide. A previously healthy 16-year-old boy presented with generalized rash, fever, severe abdominal pain, and abnormal liver function within 4 d. Chickenpox was suspected, and acyclovir and intravenous immunoglobulin were started on admission. However, the p… Show more

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Cited by 6 publications
(7 citation statements)
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“…Normally, we tend to focus more on immunocompromised people because severe varicella mostly occurs in children and immunodeficient people [12]. However, in recent years, it has been reported that adult varicella patients with normal immune function have serious complications, such as acute respiratory distress, liver failure and cerebral venous sinus thrombosis [13][14][15][16]. Moreover, as adults typically do not voluntarily vaccinate against varicella, varicella infections in adults are likely undervalued and understudied.…”
Section: Discussionmentioning
confidence: 99%
“…Normally, we tend to focus more on immunocompromised people because severe varicella mostly occurs in children and immunodeficient people [12]. However, in recent years, it has been reported that adult varicella patients with normal immune function have serious complications, such as acute respiratory distress, liver failure and cerebral venous sinus thrombosis [13][14][15][16]. Moreover, as adults typically do not voluntarily vaccinate against varicella, varicella infections in adults are likely undervalued and understudied.…”
Section: Discussionmentioning
confidence: 99%
“…She was also successfully treated with acyclovir and immunosuppression. 15 Survival data in older children and adults are sparse, most of whom underwent liver transplantation or expired. 5,6,8 The third reported case was of a 4-year-old child with influenza infection H3N2 who improved with plasmapheresis and antiviral therapy.…”
Section: Discussionmentioning
confidence: 99%
“…Haematological disorders include mild neutropaenia and thrombocytopaenia, rare purpura fulminans, disseminated intravascular coagulation, and Henoch-Schönlein purpura, which could be clinically presented as "varicella haemorrhagica" [2,[12][13][14][15]. Acute liver failure (ALF) and hemophagocytic lymphohistiocytosis (HLH) are extremely rare complications induced by VZV infection [16]. Secondary bacterial infection of skin lesions, usually due to Staphylococcus aureus or Streptococcus pyogenes, and secondary bacterial pneumonia dominate among other bacterial complications [2,7].…”
Section: Discussionmentioning
confidence: 99%