Varicella infection in a pediatric AIDS patient presenting as umbilicated papules.
An 8-year-old girl with acquired immunodeficiency syndrome presented with fever and alteration of consciousness. She had a history of persistent cryptococcal meningitis. She developed multiple discrete umbilicated papules that resembled cutaneous cryptococcosis on the second day of admission. Skin biopsy revealed an ulcer with a wedge-shaped necrosis of the dermis. The edge of the ulcer showed intracellular edema, margination of nucleoplasm and multinucleated cells, consistent with herpes infection. The diagnosis of varicella-zoster virus infection was confirmed by the identification of herpesvirus DNA from the lesion and differentiation from other herpesviruses by restriction fragment length polymorphism (RFLP) method. Intravenous acyclovir was given at a dose of 500 mg/m2, three times daily for 14 days which resulted in resolution of the skin lesions within 2 weeks.
Umpuchineewan
Jutamas
J
Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Wananukul
Siriwan
S
Sakulwira
Kamol
K
Poovoravan
Yong
Y
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000212:Acyclovir / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D002644:Chickenpox / Q000150:complications / Q000188:drug therapy / Q000473:pathology* / Q000821:virology; D002648:Child; D004279:DNA, Viral / Q000302:isolation & purification; D005076:Exanthema / Q000188:drug therapy / Q000209:etiology / Q000473:pathology* / Q000821:virology; D017809:Fatal Outcome; D005260:Female; D014645:Herpesvirus 3, Human / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D012150:Polymorphism, Restriction Fragment Length; D012883:Skin Ulcer / Q000188:drug therapy / Q000209:etiology / Q000473:pathology* / Q000821:virology
D000998:Antiviral Agents; D004279:DNA, Viral; D000212:Acyclovir