[Varicella zoster virus infection after bone marrow transplant. Unusual presentation and importance of prevention].
BACKGROUND
Leukemeia and lymphoproliferative disease are associated with a high risk of varicela-zoster virus (VZV) infection. Although infrequent, visceral involvement can be fatal. We report two cases of patients presenting severe VZV infection after bone marrow transplantation.


METHODS
The first patient was a 42-year old man who received an allogeneic bone marrow transplantation for chronic myelogenous leukemia. A severe graft-versus-host reaction occurred. Three months after discontinuing VZV prophylaxis, VZV transverse myelitis was diagnosed, leading to death despite prompt treatment with acyclovir. The second patient was a 42-year-old woman treated with autologous bone marrow transplantation for lymphoma. She developed acute viral pancreatitis one month after discontinuing VZV prophylaxis. Recovery was achieved with intravenous treatment.


CONCLUSIONS
These two cases illustrate the potential gravity of VZV infection after bone marrow transplantation. These observations point to the need for revisiting the duration of VZV prophylaxis.
Ladrière
M
M
Service de Maladies infectieuses et tropicales, Centre Hospitalier Universitaire de Nancy.
Bibes
B
B
Rabaud
C
C
Delaby
P
P
May
T
T
Canton
P
P
D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects; D016026:Bone Marrow Transplantation; D004359:Drug Therapy, Combination; D017809:Fatal Outcome; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy; D006562:Herpes Zoster / Q000175:diagnosis* / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy*; D008212:Lymphocyte Depletion; D016400:Lymphoma, Large-Cell, Immunoblastic / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D009188:Myelitis, Transverse / Q000175:diagnosis* / Q000517:prevention & control; D009894:Opportunistic Infections / Q000175:diagnosis* / Q000517:prevention & control; D010195:Pancreatitis / Q000175:diagnosis* / Q000517:prevention & control; D013116:Spinal Cord / Q000473:pathology; D014057:Tomography, X-Ray Computed
D000998:Antiviral Agents; D007166:Immunosuppressive Agents
Infection par le virus varicelle-zona après greffe de moelle osseuse. Présentations inhabituelles et intérêt de la prophylaxie.