title: [Acute abdomina pain as a presenting symptom of varicella-zoster virus infection in an allogeneic bone marrow transplant].
abstract: A 26-year old man was admitted because of acute abdominal pain. He had received an allogeneic bone marrow transplant (BMT) for aplastic anemia 6 months before. All physical, laboratory, roentgenographic, and ultrasonographic studies were performed but nondiagnostic. On the fourth hospital day the patient developed visual disturbance and on the following day skin eruption appeared. Laboratory findings revealed severe liver dysfunction. We diagnosed this case as varicella-zoster virus (VZV) infection with visceral dissemination. Antiviral therapy with acyclovir was initiated and abdominal pain markedly reduced and visual acuity was recovered after 4 days. In case of VZV infection, acute abdominal pain prior to skin eruptions is rare. However in such cases the patients are highly fatal due to visceral dissemination. Antiviral therapy begun before visceral dissemination of VZV is highly effective in preventing serious disease, whereas it is less effective after dissemination. We consider that early diagnosis and treatment of VZV infection is necessary for BMT recipients who are undergoing immunosuppressive therapy.
authors.affiliation: First Department of Medicine, Wakayama University of Medical Science.
authors.forename: T
authors.initials: T
authors.lastname: Hamanishi
authors.forename: H
authors.initials: H
authors.lastname: Nishikawa
authors.forename: M
authors.initials: M
authors.lastname: Kobayashi
authors.forename: T
authors.initials: T
authors.lastname: Nakao
authors.forename: S
authors.initials: S
authors.lastname: Ohagi
authors.forename: H
authors.initials: H
authors.lastname: Sasaki
authors.forename: G
authors.initials: G
authors.lastname: Matsumoto
authors.forename: T
authors.initials: T
authors.lastname: Sanke
authors.forename: K
authors.initials: K
authors.lastname: Nanjo
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000208:Acute Disease; D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000741:Anemia, Aplastic / Q000628:therapy; D000998:Antiviral Agents / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D006562:Herpes Zoster / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D009894:Opportunistic Infections / Q000188:drug therapy / Q000209:etiology*; D014184:Transplantation, Homologous
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir