title: [Atypical joint symptoms as initial symptoms of varicella infection in chronic myeloid leukemia].
abstract: A 25-year-old man, known to have chronic myeloid leukaemia for four years, acutely developed a fever of 39.5 degrees and severe pain in the shoulder and hip joints. There was no evidence of joint disease. Treatment with indomethacin briefly improved the symptoms, but within 72 hours the patient developed a fulminant illness with high fever and clinical as well as biochemical signs of a severe consumption coagulopathy. Herpetiform efflorescences appeared over the head and trunk shortly before death. At autopsy there was histological and immunohistochemical evidence of a varicella infection with hepatitis, oesophageal involvement and severe internal organ bleedings. In immune-compromised patients with atypical prodromal symptoms a varicella infection must be considered so that causal treatment with acyclovir and hyperimmune-globulin can be begun in time.
authors.affiliation: Abteilung für Hämatologie, Onkologie und klinische Immunologie, Universität Düsseldorf.
authors.forename: M
authors.initials: M
authors.lastname: Arning
authors.forename: C
authors.initials: C
authors.lastname: Aul
authors.forename: P
authors.initials: P
authors.lastname: Reinecke
authors.forename: K F
authors.initials: KF
authors.lastname: Bürrig
authors.forename: W
authors.initials: W
authors.lastname: Schneider
mesh_terms: D000328:Adult; D002644:Chickenpox / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006621:Hip Joint; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use; D007592:Joint Diseases / Q000188:drug therapy / Q000209:etiology*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications*; D012785:Shoulder Joint; D013997:Time Factors
chemical_list: D007213:Indomethacin
vernacular_title: Atypische Gelenksymptomatik als Erstsymptom einer Varizelleninfektion bei chronischer myeloischer Leukämie.