Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University Yokohama Seibu Hospital, 1197-1 Yasashi-cho, Asahi-ku, Yokohama City, Kanagawa, 241-0911, Japan.
St. Marianna University Toyoko Hospital, 3-435 Kosugimachi, Nakahara-ku, Kawasaki City, Kanagawa, 211-0063, Japan.
Clin J Gastroenterol. 2022 Jun;15(3):568-574. doi: 10.1007/s12328-022-01607-7. Epub 2022 Mar 2.
Varicella-zoster virus (VZV) can cause visceral disseminated VZV infection in immunocompromised patients. We experienced visceral disseminated VZV infection in an immunocompetent host. A 78-year-old woman visited our hospital complaining of abdominal pain that had persisted for 7 days. On day 3 after admission, a skin rash with blisters appeared mainly on her head and trunk that was diagnosed as generalized zoster via rapid skin VZV diagnostic kit. Esophagogastroduodenoscopy showed gastric erosions, and VZV was detected by real-time polymerase chain reaction testing of the gastric mucosal biopsy specimen. Computed tomography imaging also revealed pancreatitis and colitis, and she was diagnosed as having visceral disseminated VZV infection involving multiple organs. She was treated with acyclovir intravenously, after which her skin rash and abdominal pain disappeared. Because visceral disseminated VZV infection can occur in immunocompetent patients, this disease should be considered in patients with unexplained inflammatory lesions of the gastrointestinal tract or pancreas.
水痘带状疱疹病毒(VZV)可导致免疫功能低下患者发生内脏播散性 VZV 感染。我们遇到了一例免疫功能正常宿主发生的内脏播散性 VZV 感染。一名 78 岁女性因腹痛持续 7 天就诊于我院。入院第 3 天,患者头部和躯干出现水疱样皮疹,经快速皮肤 VZV 诊断试剂盒诊断为泛发性带状疱疹。胃镜检查发现胃黏膜糜烂,胃黏膜活检标本实时聚合酶链反应检测发现 VZV。计算机断层扫描成像还显示胰腺炎和结肠炎,患者被诊断为多器官内脏播散性 VZV 感染。静脉注射阿昔洛韦后,患者的皮疹和腹痛消失。由于内脏播散性 VZV 感染可发生在免疫功能正常的患者中,对于原因不明的胃肠道或胰腺炎症性病变患者,应考虑该病。