Primary varicella after transplantation.
A 51-year-old white woman 6 months status post cadaveric renal transplant developed a mild case of primary varicella-zoster (VZ). It is hypothesized that the limited nature of her illness was due to infection with vaccine-type VZ virus instead of wild-type VZ. Approximately 1 month prior, she had daily household contact with a child who had developed a rash after immunization with live attenuated varicella vaccine. This case highlights several important questions. Should special precautions be undertaken with renal transplant recipients naive to varicella infection after vaccination of household contacts? Should pretransplant immunization with varicella vaccine be performed routinely in naive patients? Should naive patients transplanted and maintained on immunosuppressive therapy be vaccinated? Until there are clinical trials to answer these questions, it may be instructive to consider the recommendations for pediatric and immunocompromised patients.
Scanlon-Kohlroser
Claire A
CA
Division of Renal Medicine and Transplantation Medicine, Department of Medicine and Pediatrics, University of Massachusetts Medical School and Fallon Clinic, Worcester, MA, USA.
Fan
Pang-Yen
PY
Primack
William
W
Stoff
Jeffrey S
JS
D019433:Chickenpox Vaccine / Q000009:adverse effects; D005192:Family Health; D005260:Female; D006562:Herpes Zoster / Q000209:etiology* / Q000635:transmission; D014645:Herpesvirus 3, Human; D006801:Humans; D016867:Immunocompromised Host; D016030:Kidney Transplantation / Q000276:immunology*; D008875:Middle Aged; D014611:Vaccination / Q000009:adverse effects; D014613:Vaccines, Attenuated / Q000009:adverse effects
D019433:Chickenpox Vaccine; D014613:Vaccines, Attenuated