Visceral varicella-zoster after bone marrow transplantation: report of a case series and review of the literature.

摘要: Abstract Objectives: Infection with varicella-zoster virus after bone marrow transplantation (BMT) is a common cause of morbidity and mortality. Visceral involvement may be incorrectly ascribed to graft-versus-host disease, resulting in delayed diagnosis misguided therapy. Methods: A 4-yr retrospective chart review was performed determine the presenting symptoms clinical outcome visceral infection BMT recipients. Results: Ten recipients who subsequently developed were identified. The mean age at 40 yr (range 27–56 yr). Primary hematological malignancies leukemia (N = 7), myelodysplasia 2), myelofibrosis 1). Bone transplants affected patients autologous related allogeneic 5), or matched unrelated 3). time interval from symptomatic 153 days 60–280 days). Presenting included abdominal pain all patients, nausea (60%), fever > 38°C vomiting (50%), pneumonitis skin rash (40%), diarrhea (30%). All had moderately profoundly elevated aminotransferases most pancreatic enzymes (80%). development characteristic then 6 7 days, respectively 4–10 4–14 Active disease previously been documented five eight Immunosuppressive medications increased onset seven these for suspected exacerbation disease. After recognition varicella infection, antiviral therapy promptly initiated; despite this, mortality still 50%. Conclusions: can occur as late complication both BMT. In cases, severe associated nausea, vomiting, liver preceded vesicular eruption confused With increasing application high-dose chemotherapy followed by stem cell rescue solid tumors, clinicians should aware this potentially treatable often lethal complication.