Triad of severe abdominal pain, inappropriate antidiuretic hormone secretion, and disseminated varicella-zoster virus infection preceding cutaneous manifestations after hematopoietic stem cell transplantation: utility of PCR for early recognition and therapy.
A hematopoietic stem cell transplant recipient developed abdominal pain, pneumatosis intestinalis, hepatitis, pancreatitis, and inappropriate antidiuretic hormone secretion. Blood for varicella-zoster virus (VZV) DNA polymerase chain reaction was positive. She was treated with acyclovir and subsequently developed VZV antigen-positive zoster. Detection of VZV DNA in blood may be useful for early diagnosis in immunocompromised hosts who present with zoster without skin lesions.
Rau
Rachel
R
Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1104, USA.
Fitzhugh
Courtney D
CD
Baird
Kristin
K
Cortez
Karroll J
KJ
Li
Li
L
Fischer
Steven H
SH
Cowen
Edward W
EW
Balow
James E
JE
Walsh
Thomas J
TJ
Cohen
Jeffrey I
JI
Wayne
Alan S
AS
D015746:Abdominal Pain / Q000209:etiology; D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D004279:DNA, Viral / Q000097:blood; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006562:Herpes Zoster / Q000175:diagnosis* / Q000188:drug therapy; D014645:Herpesvirus 3, Human / Q000302:isolation & purification*; D006801:Humans; D010195:Pancreatitis / Q000209:etiology; D011006:Pneumatosis Cystoides Intestinalis / Q000209:etiology; D016133:Polymerase Chain Reaction / Q000379:methods*; D014667:Vasopressins / Q000097:blood
D000998:Antiviral Agents; D004279:DNA, Viral; D014667:Vasopressins; D000212:Acyclovir