Hollenstein U, Thalhammer F, Burgmann H
Klinik für Innere Medizin I, Abt. für Infektionen und Chemotherapie, Allgemeines Krankenhaus Wien, Austria.
Infection. 1998 Sep-Oct;26(5):306-8. doi: 10.1007/BF02962254.
Primary infection with varicella-zoster virus usually is a mild, self-limiting childhood illness. However, certain rare but potentially life-threatening complications can be associated with the disease. Adults and immunosuppressed patients are at increased risk for these events. We report a case of a patient on chronic immunosuppressants with fulminant varicella infection complicated by rhabdomyolysis and disseminated intravascular coagulation. Mechanisms of muscle damage in viral diseases might be direct invasion of skeletal muscle and/or induction of harmful cytokines. Aggressive fluid therapy, alkalinization of urine and supportive measures correcting electrolyte imbalances, hypothermia and hypoxemia should result in preservation or complete restoration of renal function. Disseminated intravascular coagulation occurs in conjunction with various diseases and may range from mild laboratory abnormalities to fulminant lethal thrombosis and bleeding. Apart from elimination of the causative process therapeutic strategies are still highly disputed.
水痘-带状疱疹病毒的初次感染通常是一种轻度的、自限性的儿童疾病。然而，该疾病可能会伴有某些罕见但潜在危及生命的并发症。成人和免疫抑制患者发生这些情况的风险会增加。我们报告了一例长期使用免疫抑制剂的患者，其患暴发性水痘感染，并伴有横纹肌溶解和弥散性血管内凝血。病毒性疾病中肌肉损伤的机制可能是骨骼肌的直接侵袭和/或有害细胞因子的诱导。积极的液体疗法、尿液碱化以及纠正电解质失衡、体温过低和低氧血症的支持措施应能使肾功能得到保留或完全恢复。弥散性血管内凝血与多种疾病同时发生，其范围可能从轻度实验室异常到暴发性致命性血栓形成和出血。除了消除病因外，治疗策略仍存在很大争议。
