Department of Intensive Care Unit, Hangzhou Red-Cross Hospital, Hangzhou, Zhejiang, China.
Front Cell Infect Microbiol. 2023 Apr 19;13:1163872. doi: 10.3389/fcimb.2023.1163872. eCollection 2023.
Varicella-zoster virus (VZV) is a common and widespread human-restricted pathogen. It is famous for its dermatological manifestations, such as varicella and herpes zoster. Patients with aplastic anemia-paroxysmal nocturnal hemoglobinuria (AA-PNH) syndrome complicated with fatal disseminated varicella zoster virus infection are very rare and in danger.
A 26-year-old man with a history of AA-PNH syndrome was receiving cyclosporine and corticosteroid treatment in the hematology department. During his hospitalization in our hospital, he developed fever, abdominal pain, and lower back pain, and his face, penis, trunk, and limbs developed itchy rash. Subsequently, the patient had to undergo cardiopulmonary resuscitation because of sudden cardiac arrest, and be transferred to ICU for treatment. It was presumed that the cause is unknown severe sepsis. The patient's condition quickly progressed to multiple organ failure, accompanied by liver, respiratory, and circulatory failure, and signs of disseminated intravascular coagulation. Unfortunately, the patient died after 8 h of active treatment. Finally, we collected all the evidence and concluded that the patient died of AA-PNH syndrome combined with poxzoster virus.
AA-PNH syndrome patients treated with steroids and immunosuppressants are prone to various infections, considering that herpes virus infection with chickenpox and rash as the initial manifestations is characterized by rapid progress and often accompanied by serious complications. It is more difficult to distinguish it from AA-PNH syndrome with skin bleeding points. If it is not identified in time, it may delay the treatment opportunity, make the condition worse, and cause serious adverse prognosis. Therefore, clinicians need to pay attention to it.
水痘-带状疱疹病毒（VZV）是一种常见且广泛存在于人类中的病原体。它以其皮肤表现而闻名，如水痘和带状疱疹。再生障碍性贫血-阵发性睡眠性血红蛋白尿（AA-PNH）综合征并发致命播散性水痘带状疱疹病毒感染的患者非常罕见且处于危险之中。
一名 26 岁男性，有 AA-PNH 综合征病史，正在血液科接受环孢素和皮质类固醇治疗。在我院住院期间，他出现发热、腹痛和腰痛，面部、阴茎、躯干和四肢出现瘙痒性皮疹。随后，患者因心脏骤停不得不进行心肺复苏，并转至 ICU 治疗。病因不明的严重败血症被认为是主要原因。患者的病情迅速进展为多器官衰竭，伴有肝、呼吸和循环衰竭以及弥漫性血管内凝血的迹象。不幸的是，尽管经过 8 小时的积极治疗，患者还是死亡了。最后，我们收集了所有证据并得出结论，患者死于 AA-PNH 综合征合并带状疱疹病毒感染。
接受类固醇和免疫抑制剂治疗的 AA-PNH 综合征患者容易发生各种感染，由于疱疹病毒感染以水痘和皮疹为初始表现，其特点是进展迅速，常伴有严重并发症，因此更难与以皮肤出血点为特征的 AA-PNH 综合征相区别。如果不能及时识别，可能会延误治疗时机，使病情恶化，并导致严重的不良预后。因此，临床医生需要注意这一点。
