Abstract
Varicella-zoster virus (VZV) usually causes localized zoster in adults. However, in immunocompromised patients, it can cause systemic infection accompanied by complications such as pneumonia, encephalitis, and hepatitis. Although most of critically ill patients in intensive care unit (ICU) are immunologically compromised, they are usually not considered to be at risk for systemic VZV infection.We report two cases of systemic VZV infection occurring in critically ill patients in an ICU. One patient was a 69-year-old man with Streptococcus pneumoniae-induced purpurafulminans, and the other was a 75-year-old woman with severe acute pancreatitis. During the clinical course in the ICU, characteristic vesicles with umbilical fossa appeared diffusely and bilaterally on their face, trunk, and extremities. VZV-specific IgG levels were confirmed to be elevated compared to that of the pre-onset, and a diagnosis of recurrent VZV infection was made in both patients. The patients were treated at the same ICU but did not coincide with each other; therefore a cross-infection was unlikely. They were treated with intravenous acyclovir, but the latter patient eventually died of respiratory failure.VZV infection can cause a number of serious complications, and can lead to death in some patients. Early detection and proper treatment are needed to prevent the infection from spreading out and save the patients. It might be necessary to consider antiviral prophylaxis against VZV infection for a part of critically ill patients in ICU, although the effectiveness of this approach is yet to be established.
| Original language | English |
|---|---|
| Article number | 225 |
| Journal | Virology Journal |
| Volume | 10 |
| DOIs | |
| Publication status | Published - 2013 |
Fingerprint
Keywords
- Corticosteroid therapy
- Critically ill patients
- Intensive care unit
- Opportunistic infection
- Varicella-zoster virus
ASJC Scopus subject areas
- Virology
- Infectious Diseases
Cite this
Systemic varicella-zoster virus infection in two critically ill patients in an intensive care unit. / Hagiya, Hideharu; Kimura, Maya; Miyamoto, Toru; Otsuka, Fumio.
In: Virology Journal, Vol. 10, 225, 2013.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Systemic varicella-zoster virus infection in two critically ill patients in an intensive care unit
AU - Hagiya, Hideharu
AU - Kimura, Maya
AU - Miyamoto, Toru
AU - Otsuka, Fumio
PY - 2013
Y1 - 2013
N2 - Varicella-zoster virus (VZV) usually causes localized zoster in adults. However, in immunocompromised patients, it can cause systemic infection accompanied by complications such as pneumonia, encephalitis, and hepatitis. Although most of critically ill patients in intensive care unit (ICU) are immunologically compromised, they are usually not considered to be at risk for systemic VZV infection.We report two cases of systemic VZV infection occurring in critically ill patients in an ICU. One patient was a 69-year-old man with Streptococcus pneumoniae-induced purpurafulminans, and the other was a 75-year-old woman with severe acute pancreatitis. During the clinical course in the ICU, characteristic vesicles with umbilical fossa appeared diffusely and bilaterally on their face, trunk, and extremities. VZV-specific IgG levels were confirmed to be elevated compared to that of the pre-onset, and a diagnosis of recurrent VZV infection was made in both patients. The patients were treated at the same ICU but did not coincide with each other; therefore a cross-infection was unlikely. They were treated with intravenous acyclovir, but the latter patient eventually died of respiratory failure.VZV infection can cause a number of serious complications, and can lead to death in some patients. Early detection and proper treatment are needed to prevent the infection from spreading out and save the patients. It might be necessary to consider antiviral prophylaxis against VZV infection for a part of critically ill patients in ICU, although the effectiveness of this approach is yet to be established.
AB - Varicella-zoster virus (VZV) usually causes localized zoster in adults. However, in immunocompromised patients, it can cause systemic infection accompanied by complications such as pneumonia, encephalitis, and hepatitis. Although most of critically ill patients in intensive care unit (ICU) are immunologically compromised, they are usually not considered to be at risk for systemic VZV infection.We report two cases of systemic VZV infection occurring in critically ill patients in an ICU. One patient was a 69-year-old man with Streptococcus pneumoniae-induced purpurafulminans, and the other was a 75-year-old woman with severe acute pancreatitis. During the clinical course in the ICU, characteristic vesicles with umbilical fossa appeared diffusely and bilaterally on their face, trunk, and extremities. VZV-specific IgG levels were confirmed to be elevated compared to that of the pre-onset, and a diagnosis of recurrent VZV infection was made in both patients. The patients were treated at the same ICU but did not coincide with each other; therefore a cross-infection was unlikely. They were treated with intravenous acyclovir, but the latter patient eventually died of respiratory failure.VZV infection can cause a number of serious complications, and can lead to death in some patients. Early detection and proper treatment are needed to prevent the infection from spreading out and save the patients. It might be necessary to consider antiviral prophylaxis against VZV infection for a part of critically ill patients in ICU, although the effectiveness of this approach is yet to be established.
KW - Corticosteroid therapy
KW - Critically ill patients
KW - Intensive care unit
KW - Opportunistic infection
KW - Varicella-zoster virus
UR - http://www.scopus.com/inward/record.url?scp=84879808666&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84879808666&partnerID=8YFLogxK
U2 - 10.1186/1743-422X-10-225
DO - 10.1186/1743-422X-10-225
M3 - Article
C2 - 23829348
AN - SCOPUS:84879808666
VL - 10
JO - Virology Journal
JF - Virology Journal
SN - 1743-422X
M1 - 225
ER -