NATO Role 3 Multi-National Medical Unit, Kandahar Airfield, Afghanistan; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center San Diego, San Diego, CA, USA; Department of Pulmonary and Critical Care Medicine, Naval Medical Center San Diego, San Diego, CA, USA.
NATO Role 3 Multi-National Medical Unit, Kandahar Airfield, Afghanistan; Department of Pulmonary and Critical Care Medicine, Naval Medical Center San Diego, San Diego, CA, USA.
J Clin Virol. 2014 Jan;59(1):63-6. doi: 10.1016/j.jcv.2013.10.027. Epub 2013 Nov 1.
Varicella-zoster virus (VZV) infections have declined in many industrialized countries due to vaccination with the attenuated Oka strain virus. Rare cases of severe, disseminated vaccine-strain VZV infection have occurred in the immunocompromised, although rarely in HIV-infected persons. We describe a man with previously-undiagnosed human immunodeficiency virus (HIV) infection who received VZV vaccination and subsequently presented to a combat hospital in Afghanistan with disseminated varicella, respiratory failure, and sepsis. The patient recovered with ventilator and hemodynamic support, intravenous acyclovir, and empiric antibiotic therapy. DNA sequencing detected Oka strain virus from patient blood specimens. Although safe in most populations, the VZV vaccine may cause life-threatening disease in immunocompromised patients. Improved detection of HIV infection may be useful in preventing such cases.
水痘带状疱疹病毒（VZV）感染在许多工业化国家因接种减毒 Oka 株病毒而减少。免疫功能低下者中偶有严重播散性疫苗株 VZV 感染病例发生，虽然在 HIV 感染者中罕见。我们描述了一名患有先前未确诊的人类免疫缺陷病毒（HIV）感染的男子，他接种了 VZV 疫苗，随后在阿富汗的一家战斗医院出现播散性水痘、呼吸衰竭和败血症。患者在呼吸机和血流动力学支持、静脉用阿昔洛韦和经验性抗生素治疗下康复。从患者血液标本中检测到 Oka 株病毒。尽管在大多数人群中安全，但 VZV 疫苗可能在免疫功能低下者中引起危及生命的疾病。提高对 HIV 感染的检测可能有助于预防此类病例。
