Disseminated varicella infection due to the vaccine strain of varicella-zoster virus, in a patient with a novel deficiency in natural killer T cells.
An 11-year-old girl presented with a papulovesicular rash and severe respiratory distress 5 weeks after receiving varicella vaccine. Restriction fragment length-polymorphism analysis of virus isolated from an endotracheal-tube aspirate and from bronchoalveolar lavage revealed that this patient's illness was due to the Oka vaccine strain of varicella. An extensive immunologic analysis failed to identify a known diagnostic entity to explain her susceptibility to this attenuated vaccine strain. Analysis of her lymphocytes on separate occasions, months after recovery from her illness, revealed a profound deficiency of natural killer T (NKT) cells and of NKT-cell activity, suggesting that NKT cells contribute to host defense against varicella virus.
D000956:Antigens, Viral / Q000276:immunology; D019433:Chickenpox Vaccine / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D004279:DNA, Viral / Q000737:chemistry / Q000235:genetics; D005260:Female; D006562:Herpes Zoster / Q000276:immunology* / Q000473:pathology; D014645:Herpesvirus 3, Human / Q000235:genetics / Q000276:immunology*; D006801:Humans; D007107:Immune System / Q000166:cytology / Q000473:pathology; D016867:Immunocompromised Host / Q000276:immunology*; D007694:Killer Cells, Natural / Q000276:immunology*; D012150:Polymorphism, Restriction Fragment Length; D014611:Vaccination / Q000009:adverse effects*; D014613:Vaccines, Attenuated / Q000009:adverse effects / Q000627:therapeutic use
D000956:Antigens, Viral; D019433:Chickenpox Vaccine; D004279:DNA, Viral; D014613:Vaccines, Attenuated