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Relapsing hemorrhagic varicella

H Suwabe1, H Yabe, Y Tsutsumi

  • 1Department of Pathology, Tokai University School of Medicine, Isehara, Japan.

Pathology International
|August 1, 1996
PubMed
Summary

A 15-year-old boy undergoing chemotherapy for acute myeloblastic leukemia developed a lethal varicella infection. This severe varicella-zoster virus reactivation occurred despite prior bone marrow transplantation and graft-versus-host disease treatment.

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Area of Science:

  • * Hematology
  • * Virology
  • * Immunology

Background:

  • * A 15-year-old male with a history of acute myeloblastic leukemia (AML) underwent chemotherapy and allogeneic bone marrow transplantation.
  • * The patient had previously overcome graft-versus-host disease (GVHD).

Observation:

  • * The patient presented with progressive, hemorrhagic skin eruptions over three weeks.
  • * Histological examination revealed intranuclear inclusions in epidermal, follicular, and endothelial cells.

Findings:

  • * Immunohistochemical and electron microscopy confirmed the presence of varicella-zoster virus (VZV).
  • * The findings indicate a severe VZV reactivation during immunosuppression for AML and post-transplant complications.

Implications:

  • * This case highlights the risk of severe VZV reactivation in immunocompromised patients, even after bone marrow transplantation.
  • * It underscores the importance of vigilant monitoring and potential prophylactic strategies for VZV in this vulnerable population.

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