Published online Oct 26, 2021. doi: 10.12998/wjcc.v9.i30.9168
Peer-review started: April 20, 2021
First decision: July 15, 2021
Revised: July 16, 2021
Accepted: September 14, 2021
Article in press: September 14, 2021
Published online: October 26, 2021
Visceral disseminated varicella-zoster virus (VZV) infection is a rare but life-threatening disease. In transplant recipients with VZV infection, visceral dissemination may develop without skin eruptions, which leads to the failure of early diagnosis.
The patient was a 33-year-old male renal recipient who was referred to our hospital with severe upper abdominal pain of 3-d duration. On admission, the patient rapidly developed septic shock and multiple organ dysfunction syndrome with liver dysfunction and acute kidney injury. Next-generation sequencing of peripheral blood yielded 39224 sequence reads of VZV, and real-time polymerase chain reaction for VZV was positive, with 1.2 × 107 copies/mL. The final diagnosis was visceral disseminated VZV infection. Acyclovir and supportive therapy were started, but the patient died of severe visceral organ damage 16 h after admission.
Visceral disseminated VZV infection is possible in renal transplant recipients presenting abdominal pain and rapidly-evolving organ damage without skin involvement.
Core Tip: In transplant recipients, visceral disseminated varicella-zoster virus (VZV) infection may develop without skin eruptions, which leads to the failure of early diagnosis and fatal outcome. Early diagnosis and prompt antiviral therapy is the key to successful treatment. Next-generation sequencing is a promising tool for early de