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Fatal massive hepatic necrosis from varicella-zoster hepatitis
The American Journal of Gastroenterology
|November 1, 1980
Summary
A rare case of varicella-zoster hepatitis led to fatal liver necrosis in a 64-year-old woman. This study highlights the severe potential of the varicella-zoster virus (VZV) even without shingles.
Area of Science:
- Hepatology
- Virology
- Pathology
Background:
- Varicella-zoster virus (VZV) typically causes chickenpox and shingles.
- VZV hepatitis is a rare but potentially severe complication.
- This report details an unusual fatal case of VZV hepatitis.
Observation:
- A 64-year-old female presented with fatal massive hepatic necrosis.
- The patient had a history of chickenpox but no shingles.
- Liver biopsy revealed eosinophilic intranuclear inclusions and herpesvirus virions.
Findings:
- Serologic studies confirmed recent and remote VZV infection.
- Electron microscopy identified herpesvirus virions in the liver.
- The cause of death was massive hepatic necrosis attributed to VZV.
Implications:
- This case underscores the potential for severe VZV reactivation without typical zoster manifestations.
- Splenectomy and immunosuppression may play a role in VZV dissemination.
- Understanding VZV pathogenesis is crucial for managing severe liver disease.