Acquired intestinal aganglionosis after a lytic infection with varicella-zoster virus.
OBJECTIVE
In this report, we present the first case of an immunologically impaired child surviving a lytic varicella-zoster virus infection affecting the enteric nervous system. In histological findings, myenteric and submucous enteric ganglia were nearly completely absent owing to virus infection.


METHODS
A 3-year-old girl with acute lymphoblastic leukemia and generalized varicella-zoster infection developed an ileus. She underwent multiple laparotomies in which histological sections of the entire small intestine could be obtained.


RESULTS
The histological evaluation of these samples showed a generalized aganglionosis with inflammatory residuals. A more detailed immunohistochemical analysis using neuronal (PGP, enolase), glial (S100), and lymphocytic (LCA) antibodies demonstrated a nearly complete neuronal loss.


CONCLUSIONS
To our knowledge, this is the first case of a secondary intestinal aganglionosis after varicella-zoster virus infection.
Holland-Cunz
Stefan
S
Department of Pediatric Surgery, University of Heidelberg, 69120 Heidelberg, Germany. stefan_holland-cunz@med.uni-heidelberg.de
Göppl
Max
M
Rauch
Ulrich
U
Bär
Claudia
C
Klotz
Markus
M
Schäfer
Karl-Herbert
KH
D002675:Child, Preschool; D017615:Enteric Nervous System / Q000473:pathology* / Q000821:virology*; D005260:Female; D006562:Herpes Zoster / Q000150:complications* / Q000209:etiology; D006801:Humans; D045823:Ileus / Q000209:etiology; D016867:Immunocompromised Host; D007410:Intestinal Diseases / Q000209:etiology*; D007421:Intestine, Small / Q000294:innervation*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications