Varicella zoster gastritis in a bone marrow transplant recipient.
A case is reported of a patient who had previously undergone autologous bone marrow transplantation for recurrent Hodgkin's disease. The patient developed a generalised vesicular skin eruption. The clinical diagnosis was of disseminated shingles. Herpes viral particles were identified within the vesicular fluid by electron microscopy and using a specific monoclonal antibody to varicella zoster virus (VZV), positive immunofluorescence was detected in scrapings from the base of a vesicle. Gastroscopy and biopsy were performed because of severe abdominal pain and vomiting. The histological features were of non-specific active inflammation. Despite the histological absence of viral inclusions electron microscopy of the gastric biopsy revealed the presence of intranuclear herpes viral particles with a diameter of 90-100 nm. VZV specific DNA was detected by the polymerase chain reaction in the gastric biopsy extract. The patient was treated with acyclovir and made a full recovery.
McCluggage
W G
WG
Department of Pathology, Royal Group of Hospitals, Belfast.
Fox
J D
JD
Baillie
K E
KE
Coyle
P V
PV
Jones
F G
FG
O'Hara
M D
MD
D000328:Adult; D016026:Bone Marrow Transplantation; D004279:DNA, Viral / Q000032:analysis; D005455:Fluorescent Antibody Technique; D005756:Gastritis / Q000473:pathology / Q000821:virology*; D006562:Herpes Zoster / Q000150:complications* / Q000473:pathology; D014645:Herpesvirus 3, Human / Q000235:genetics / Q000648:ultrastructure; D006801:Humans; D008297:Male; D008854:Microscopy, Electron; D016133:Polymerase Chain Reaction; D013270:Stomach / Q000821:virology*
D004279:DNA, Viral