Disseminated Chickenpox Following Live Varicella Vaccination in a Crohn's Disease Patient on Combination
Quintin Solano1, Sarah Uttal2, Peter D R Higgins2
1Department of Internal Medicine, Michigan Medicine, Ann Arbor, Michigan, USA.
Abstract:
Novel therapeutics used in the treatment of inflammatory bowel disease pose an increased risk of viral reactivation in patients. We present a case of a patient with refractory Crohn's disease (CD) who developed primary varicella (chickenpox) of a vaccine-viral strain after receiving combination immunosuppression with high-dose corticosteroids, tumor necrosis factor inhibitor (TNFi), and a Janus kinase inhibitor (JAKi) in the hospital. While this patient recovered and did not experience long term adverse effects, her case provides an opportunity for improvement. To improve safety, healthcare facilities should develop protocols that use electronic medical records enhanced with clinical decision support systems to identify and protect immunocompromised patients from inappropriate live vaccinations.
Related Concept Videos
Immunodeficiency Diseases
There are three main causes of immunodeficiency...
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...


