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Matsuo Y, Igarashi Y, Aoyama N, Satta Y, Oikawa R, Noguchi Y, Takahashi H, Matsumoto N, Yamamoto H, Itoh F. Visceral disseminated varicella-zoster virus infection in an immunocompetent host. Clin J Gastroenterol 2022; 15:568-574. [PMID: 35235151 DOI: 10.1007/s12328-022-01607-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 02/07/2022] [Indexed: 11/25/2022]
Abstract
Varicella-zoster virus (VZV) can cause visceral disseminated VZV infection in immunocompromised patients. We experienced visceral disseminated VZV infection in an immunocompetent host. A 78-year-old woman visited our hospital complaining of abdominal pain that had persisted for 7 days. On day 3 after admission, a skin rash with blisters appeared mainly on her head and trunk that was diagnosed as generalized zoster via rapid skin VZV diagnostic kit. Esophagogastroduodenoscopy showed gastric erosions, and VZV was detected by real-time polymerase chain reaction testing of the gastric mucosal biopsy specimen. Computed tomography imaging also revealed pancreatitis and colitis, and she was diagnosed as having visceral disseminated VZV infection involving multiple organs. She was treated with acyclovir intravenously, after which her skin rash and abdominal pain disappeared. Because visceral disseminated VZV infection can occur in immunocompetent patients, this disease should be considered in patients with unexplained inflammatory lesions of the gastrointestinal tract or pancreas.
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Affiliation(s)
- Yasumasa Matsuo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University Yokohama Seibu Hospital, 1197-1 Yasashi-cho, Asahi-ku, Yokohama City, Kanagawa, 241-0911, Japan. .,St. Marianna University Toyoko Hospital, 3-435 Kosugimachi, Nakahara-ku, Kawasaki City, Kanagawa, 211-0063, Japan.
| | - Yosuke Igarashi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University Yokohama Seibu Hospital, 1197-1 Yasashi-cho, Asahi-ku, Yokohama City, Kanagawa, 241-0911, Japan
| | - Natsumi Aoyama
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University Yokohama Seibu Hospital, 1197-1 Yasashi-cho, Asahi-ku, Yokohama City, Kanagawa, 241-0911, Japan
| | - Yosuke Satta
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University Yokohama Seibu Hospital, 1197-1 Yasashi-cho, Asahi-ku, Yokohama City, Kanagawa, 241-0911, Japan
| | - Ritsuko Oikawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki City, 216-8511, Japan
| | - Yohei Noguchi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University Yokohama Seibu Hospital, 1197-1 Yasashi-cho, Asahi-ku, Yokohama City, Kanagawa, 241-0911, Japan
| | - Hideaki Takahashi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University Yokohama Seibu Hospital, 1197-1 Yasashi-cho, Asahi-ku, Yokohama City, Kanagawa, 241-0911, Japan
| | - Nobuyuki Matsumoto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University Yokohama Seibu Hospital, 1197-1 Yasashi-cho, Asahi-ku, Yokohama City, Kanagawa, 241-0911, Japan
| | - Hiroyuki Yamamoto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki City, 216-8511, Japan.,Department of Bioinformatics, St. Marianna University Graduate School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki City, 216-8511, Japan
| | - Fumio Itoh
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki City, 216-8511, Japan
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Betkiewicz A, Fornalczyk M, Urban K, Jarecka B, Obuchowicz A. Sialadenitis as chickenpox complication in a 6-year-old girl. IDCases 2021; 23:e01052. [PMID: 33598402 PMCID: PMC7868919 DOI: 10.1016/j.idcr.2021.e01052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/15/2021] [Accepted: 01/15/2021] [Indexed: 12/03/2022] Open
Abstract
In the 6.year old girl with chickenpox we diagnosed an typical complication in the shape of sialadenitis (especially submaxillitis). Within the last twenty years, only in one child the relationship between sialadenitis and varicella-zoster virus infection has been suggested. Our observation has important clinical significance.
Chickenpox is considered as a mild disease, but sometimes it is associated with complications. Among them sialadenitis is mentioned sporadically. We describe a case of the 6-year-old girl suffering from complicated chickenpox. On the basis of clinical data and ultrasound image we diagnosed in her inflammation of both submandibular glands. Moreover, the ultrasound image suggested possibility of an inflammation developing in the left parotid gland.
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Affiliation(s)
- A Betkiewicz
- Department of Paediatrics, Specialist Hospital No 2 in Bytom, Poland
| | - M Fornalczyk
- Department of Paediatrics, Specialist Hospital No 2 in Bytom, Poland
| | - K Urban
- Department of Paediatrics, Specialist Hospital No 2 in Bytom, Poland
| | - B Jarecka
- Department of Paediatrics in Bytom, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Poland
| | - A Obuchowicz
- Department of Paediatrics in Bytom, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Poland
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Al-Turab M, Chehadeh W. Varicella infection in the Middle East: Prevalence, complications, and vaccination. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2018; 23:19. [PMID: 29887897 PMCID: PMC5961286 DOI: 10.4103/jrms.jrms_979_17] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 12/20/2017] [Accepted: 01/22/2018] [Indexed: 02/01/2023]
Abstract
Varicella (chickenpox) is the primary infection of varicella-zoster virus (VZV), it is a mild self-limiting infection, but it is also highly contagious and can cause severe complications among high-risk group of individuals. It is usually a childhood infection providing lifelong immunity, but adults without varicella history are also susceptible to infection. High-risk group of individuals is more likely to develop serious complications. Varicella vaccine was introduced to protect this group of individuals and to prevent epidemic spread of VZV infection in a community. Thus, it was added to the recommended vaccination schedules for children in most developed countries. This review aimed to outline varicella status, seroprevalence, complications, and vaccination in the Middle East region. Based on our findings, children were the most affected age group, but there are also adult cases due to high number of expatriates, especially in Gulf Cooperation Council countries. Central nervous system involvements and skin diseases followed by varicella pneumonia were the most varicella-associated complications. Varicella vaccine was introduced in most Middle East countries, either mandatory by the Ministries of Health or optional in the private clinics. Few numbers of studies have reported an obvious reduction in varicella prevalence, hospitalizations, and deaths in the Middle East following varicella vaccination. A basic database about varicella infection before the initiation and implementation of a vaccination policy is essential to determine the target group of individuals. As far as our knowledge, this is the first review about varicella infection in the Middle East.
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Affiliation(s)
- Mariam Al-Turab
- Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait
| | - Wassim Chehadeh
- Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait
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Saman S, Henes JC, Niepel D, Bosmüller H, Werner CR, Lauer UM, Malek NP, Xenitidis T. [Varicella gastritis under immunosuppression : Case report of a woman after lung transplantation due to granulomatosis with polyangiitis]. Internist (Berl) 2017; 58:855-858. [PMID: 28405696 DOI: 10.1007/s00108-017-0231-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A 35-year-old woman who had previously undergone a lung transplantation presented with severe abdominal pain and vomiting. The gastroscopy showed diffuse ulcerative gastric lesions. Tests for varicella zoster virus and Epstein-Barr virus via polymerase chain reactions (PCR) on endoscopically obtained gastric biopsies were found to be positive and confirmed varicella gastritis. Intravenous antiviral therapy with acyclovir was administered resulting in a normalization of all clinical symptoms, especially of abdominal pain and inflammation parameters.
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Affiliation(s)
- S Saman
- Abteilung Innere Medizin I (Hepatologie, Gastroenterologie, Infektiologie), Universitätsklinikum Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Deutschland.
| | - J-C Henes
- Abteilung Innere Medizin II (Onkologie, Hämatologie, Rheumatologie, Immunologie, Pulmonologie), Universitätsklinikum Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Deutschland
| | - D Niepel
- Abteilung Innere Medizin I (Hepatologie, Gastroenterologie, Infektiologie), Universitätsklinikum Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Deutschland
| | - H Bosmüller
- Abteilung Allgemeine Pathologie, Institut für Pathologie und Neuropathologie, Liebermeisterstr. 8, 72076, Tübingen, Deutschland
| | - C R Werner
- Abteilung Innere Medizin I (Hepatologie, Gastroenterologie, Infektiologie), Universitätsklinikum Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Deutschland
| | - U M Lauer
- Abteilung Innere Medizin I (Hepatologie, Gastroenterologie, Infektiologie), Universitätsklinikum Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Deutschland
| | - N P Malek
- Abteilung Innere Medizin I (Hepatologie, Gastroenterologie, Infektiologie), Universitätsklinikum Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Deutschland
| | - T Xenitidis
- Abteilung Innere Medizin II (Onkologie, Hämatologie, Rheumatologie, Immunologie, Pulmonologie), Universitätsklinikum Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Deutschland
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Habas F, Jacquot A, Carbasse A, Cambonie G. [Life-threatening erosive gastritis in a child with varicella-induced thrombocytopenia]. Arch Pediatr 2014; 21:903-4. [PMID: 24951270 DOI: 10.1016/j.arcped.2014.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 04/19/2014] [Accepted: 05/15/2014] [Indexed: 11/19/2022]
Affiliation(s)
- F Habas
- Pédiatrie néonatale et réanimations, hôpital Arnaud de Villeneuve, 371, avenue du Doyen-G.-Giraud, 34295 Montpellier cedex 5, France
| | - A Jacquot
- Pédiatrie néonatale et réanimations, hôpital Arnaud de Villeneuve, 371, avenue du Doyen-G.-Giraud, 34295 Montpellier cedex 5, France
| | - A Carbasse
- Urgence et post-urgence, CHU de Montpellier, 34000 Montpellier, France
| | - G Cambonie
- Pédiatrie néonatale et réanimations, hôpital Arnaud de Villeneuve, 371, avenue du Doyen-G.-Giraud, 34295 Montpellier cedex 5, France.
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Gershon AA, Gershon MD. Pathogenesis and current approaches to control of varicella-zoster virus infections. Clin Microbiol Rev 2013; 26:728-43. [PMID: 24092852 PMCID: PMC3811230 DOI: 10.1128/cmr.00052-13] [Citation(s) in RCA: 127] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Varicella-zoster virus (VZV) was once thought to be a fairly innocuous pathogen. That view is no longer tenable. The morbidity and mortality due to the primary and secondary diseases that VZV causes, varicella and herpes zoster (HZ), are significant. Fortunately, modern advances, including an available vaccine to prevent varicella, a therapeutic vaccine to diminish the incidence and ameliorate sequelae of HZ, effective antiviral drugs, a better understanding of VZV pathogenesis, and advances in diagnostic virology have made it possible to control VZV in the United States. Occult forms of VZV-induced disease have been recognized, including zoster sine herpete and enteric zoster, which have expanded the field. Future progress should include development of more effective vaccines to prevent HZ and a more complete understanding of the consequences of VZV latency in the enteric nervous system.
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