Prolonged excretion of herpesvirus varicellae in a child with acute lymphoblastic leukaemia

An eight-year-old girl with acute lymphoblastic leukaemia (ALL) in remission presented with varicella. Zoster immune globulin was not given, but treatment with acyclovir was commenced the day after presentation and continued for five days. Many of the original vesicles ulcerated and persisted for periods in excess of three months, finally leaving residual scarring. Further new vesicles appeared at 80 days and 109 days, and virus was again visualised by electron microscopy. Seroconversion was not demonstrated, although the child has in the past responded serologically to other viruses. A series of other infections afflicting the child at about the same time is documented and the possible implications are discussed.